Healthcare Provider Details

I. General information

NPI: 1346623188
Provider Name (Legal Business Name): AIMI KUWAHARA D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2015
Last Update Date: 11/20/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1424 BROADWAY
EVERETT WA
98201-1720
US

IV. Provider business mailing address

1424 BROADWAY
EVERETT WA
98201-1720
US

V. Phone/Fax

Practice location:
  • Phone: 425-551-1000
  • Fax:
Mailing address:
  • Phone: 425-551-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDENT.DE.60567654
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: