Healthcare Provider Details

I. General information

NPI: 1447882725
Provider Name (Legal Business Name): LAEL BANNER DDS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2020
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8540 1ST AVE NW STE. 8
SEATTLE WA
98117
US

IV. Provider business mailing address

8540 1ST AVE NW STE. 8
SEATTLE WA
98117
US

V. Phone/Fax

Practice location:
  • Phone: 206-801-3900
  • Fax: 206-902-9877
Mailing address:
  • Phone: 206-801-3900
  • Fax: 206-902-9877

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. LAEL B BANNER
Title or Position: DOCTOR OWNER
Credential: DDS
Phone: 206-801-3900