Healthcare Provider Details

I. General information

NPI: 1285572834
Provider Name (Legal Business Name): KIM ALAN MCGINNIS DDS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2026
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2121 MADISON ST STE B
EVERETT WA
98203-5375
US

IV. Provider business mailing address

2121 MADISON ST STE B
EVERETT WA
98203-5375
US

V. Phone/Fax

Practice location:
  • Phone: 425-353-3210
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. KIM ALAN MCGINNIS
Title or Position: OWNER
Credential: DDS
Phone: 425-353-3210