Healthcare Provider Details

I. General information

NPI: 1902011794
Provider Name (Legal Business Name): 1ST IMPRESSIONS DENTAL & DENTURE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9835 16TH AVE SW STE 101
SEATTLE WA
98106-2830
US

IV. Provider business mailing address

9835 16TH AVE SW STE 101
SEATTLE WA
98106-2830
US

V. Phone/Fax

Practice location:
  • Phone: 206-763-8883
  • Fax: 206-768-8887
Mailing address:
  • Phone: 206-763-8883
  • Fax: 206-768-8887

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code122400000X
TaxonomyDenturist
License Number
License Number State

VIII. Authorized Official

Name: QUOC W NGO
Title or Position: DENTURIST OWNER
Credential: L..D.
Phone: 20676388883