Healthcare Provider Details

I. General information

NPI: 1760207740
Provider Name (Legal Business Name): ELIF BUYUKCELIK DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2024
Last Update Date: 11/15/2024
Certification Date: 11/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23320 HIGHWAY 99
EDMONDS WA
98026-8744
US

IV. Provider business mailing address

23320 HIGHWAY 99
EDMONDS WA
98026-8744
US

V. Phone/Fax

Practice location:
  • Phone: 425-789-3789
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDE61588719
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: