Healthcare Provider Details

I. General information

NPI: 1912920570
Provider Name (Legal Business Name): LEE HILTON DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15955 NE 85TH ST STE 201
REDMOND WA
98052-3550
US

IV. Provider business mailing address

15955 NE 85TH ST STE 201
REDMOND WA
98052-3550
US

V. Phone/Fax

Practice location:
  • Phone: 425-882-2444
  • Fax:
Mailing address:
  • Phone: 425-882-2444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDE00005356
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: