Healthcare Provider Details

I. General information

NPI: 1740138379
Provider Name (Legal Business Name): CHAISON & CHAISON DDS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2026
Last Update Date: 03/19/2026
Certification Date: 03/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19214 BOTHELL WAY NE STE A
BOTHELL WA
98011-6066
US

IV. Provider business mailing address

19214 BOTHELL WAY NE STE A
BOTHELL WA
98011-6066
US

V. Phone/Fax

Practice location:
  • Phone: 425-483-2828
  • Fax:
Mailing address:
  • Phone: 425-483-2828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. JEREMY CHAISON
Title or Position: PRESIDENT
Credential: DDS, MSD
Phone: 425-483-2828