Healthcare Provider Details

I. General information

NPI: 1447326046
Provider Name (Legal Business Name): TIMOTHY ING-HO KUO DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/27/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12359 LAKE CITY WAY NE
SEATTLE WA
98125-5401
US

IV. Provider business mailing address

11745 23RD AVE NE
SEATTLE WA
98125-5247
US

V. Phone/Fax

Practice location:
  • Phone: 206-477-8072
  • Fax:
Mailing address:
  • Phone: 206-459-4139
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDE00008648
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: