Healthcare Provider Details

I. General information

NPI: 1427144211
Provider Name (Legal Business Name): PACIFIC ENDODONTICS, P.S.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1229 MADISON ST SUITE #1140
SEATTLE WA
98104-3586
US

IV. Provider business mailing address

1229 MADISON ST SUITE #1140
SEATTLE WA
98104-3586
US

V. Phone/Fax

Practice location:
  • Phone: 206-682-4464
  • Fax: 206-682-0673
Mailing address:
  • Phone: 206-682-4464
  • Fax: 206-682-0673

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number
License Number State

VIII. Authorized Official

Name: DR. THEODORE F PILOT
Title or Position: PRESIDENT
Credential: DDS, MS
Phone: 206-682-4464