Healthcare Provider Details

I. General information

NPI: 1023262623
Provider Name (Legal Business Name): DR GARRICK J LO DDS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2008
Last Update Date: 09/27/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8435 161ST AVE NE SUITE 102
REDMOND WA
98052-1512
US

IV. Provider business mailing address

8435 161ST AVE NE SUITE 102
REDMOND WA
98052-1512
US

V. Phone/Fax

Practice location:
  • Phone: 425-885-1151
  • Fax: 425-883-0386
Mailing address:
  • Phone: 425-885-1151
  • Fax: 425-883-0386

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. GARRICK J LO
Title or Position: OWNER
Credential: DDS
Phone: 206-851-8421