Healthcare Provider Details

I. General information

NPI: 1043207715
Provider Name (Legal Business Name): RICHARD H HWYNN DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2005
Last Update Date: 01/03/2025
Certification Date: 01/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33431 13TH PL S
FEDERAL WAY WA
98003-6357
US

IV. Provider business mailing address

955 POWELL AVE SW
RENTON WA
98057
US

V. Phone/Fax

Practice location:
  • Phone: 253-874-7646
  • Fax: 253-838-8364
Mailing address:
  • Phone: 425-277-1311
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDE00007870
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDE00007870
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: