Healthcare Provider Details

I. General information

NPI: 1841744950
Provider Name (Legal Business Name): TIINA OVIIR, DDS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2016
Last Update Date: 08/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3229 HOYT AVE STE B
EVERETT WA
98201-6404
US

IV. Provider business mailing address

3229 HOYT AVE STE B
EVERETT WA
98201-6404
US

V. Phone/Fax

Practice location:
  • Phone: 425-320-4281
  • Fax: 425-320-4285
Mailing address:
  • Phone: 425-320-4281
  • Fax: 425-320-4285

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License NumberDE00010067
License Number StateWA

VIII. Authorized Official

Name: DR. TIINA OVIIR
Title or Position: OWNER / DDS
Credential: DDS
Phone: 425-320-4281