Healthcare Provider Details

I. General information

NPI: 1114324274
Provider Name (Legal Business Name): BJ MULLIKEN DDS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2014
Last Update Date: 12/27/2024
Certification Date: 12/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16030 BOTHELL EVERETT HWY STE 280
MILL CREEK WA
98012-1599
US

IV. Provider business mailing address

16030 BOTHELL EVERETT HWY STE 280
MILL CREEK WA
98012-1599
US

V. Phone/Fax

Practice location:
  • Phone: 425-481-4974
  • Fax: 425-338-4930
Mailing address:
  • Phone: 425-481-4974
  • Fax: 425-338-4930

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number5460
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: BILL MULLIKEN
Title or Position: OWNER
Credential: DDS
Phone: 425-481-4974