Healthcare Provider Details

I. General information

NPI: 1770436024
Provider Name (Legal Business Name): STEVEN FAOUAZ DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15421 MAIN ST STE 101
MILL CREEK WA
98012-9002
US

IV. Provider business mailing address

451 BIRMINGHAM LN
SCHAUMBURG IL
60193-3167
US

V. Phone/Fax

Practice location:
  • Phone: 425-336-1894
  • Fax:
Mailing address:
  • Phone: 847-909-0840
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number70103515
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: