Healthcare Provider Details

I. General information

NPI: 1316886260
Provider Name (Legal Business Name): ANABELLA DENTAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2026
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11216 NE 15TH ST STE A
BELLEVUE WA
98004-3724
US

IV. Provider business mailing address

11216 NE 15TH ST STE A
BELLEVUE WA
98004-3724
US

V. Phone/Fax

Practice location:
  • Phone: 425-454-3221
  • Fax: 888-299-5920
Mailing address:
  • Phone: 425-454-3221
  • Fax: 888-299-5920

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: DR. CLARA H SONG
Title or Position: DENTIST
Credential: DDS
Phone: 425-454-3221