Healthcare Provider Details

I. General information

NPI: 1598695447
Provider Name (Legal Business Name): URBAN DENTAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6800 GREENWOOD AVE N
SEATTLE WA
98103-5228
US

IV. Provider business mailing address

6800 GREENWOOD AVE N
SEATTLE WA
98103-5228
US

V. Phone/Fax

Practice location:
  • Phone: 206-686-8800
  • Fax:
Mailing address:
  • Phone: 206-686-8800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: ANN KNUDSON
Title or Position: DENTIST/OWNER
Credential: DDS
Phone: 206-686-8800