Healthcare Provider Details

I. General information

NPI: 1720493265
Provider Name (Legal Business Name): MILDA CHMIELIAUSKAITE D.M.D, M.P.H
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2014
Last Update Date: 11/18/2025
Certification Date: 11/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1959 NE PACIFIC ST # B221
SEATTLE WA
98195-3804
US

IV. Provider business mailing address

1959 NE PACIFIC ST BOX 357191
SEATTLE WA
98195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 206-685-2937
  • Fax: 206-616-8577
Mailing address:
  • Phone: 206-685-2937
  • Fax: 206-616-8577

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDE61322400
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code125Q00000X
TaxonomyOral Medicine Dentistry
License NumberDE61322400
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: