Healthcare Provider Details

I. General information

NPI: 1578054342
Provider Name (Legal Business Name): NADEEM S. ESMAIL DDS MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2018
Last Update Date: 05/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3136 SQUALICUM PKWY
BELLINGHAM WA
98225-1954
US

IV. Provider business mailing address

3136 SQUALICUM PKWY
BELLINGHAM WA
98225-1954
US

V. Phone/Fax

Practice location:
  • Phone: 360-671-4859
  • Fax:
Mailing address:
  • Phone: 360-671-4859
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS0112X
TaxonomyOral and Maxillofacial Surgery Clinic/Center
License NumberDE60150330
License Number StateWA

VIII. Authorized Official

Name: DR. NADEEM S. ESMAIL
Title or Position: PHYSICIAN/DENTIST
Credential: DDS, MD
Phone: 360-671-4859