Healthcare Provider Details

I. General information

NPI: 1912170796
Provider Name (Legal Business Name): ANA LUCIA SEMINARIO DDS, PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2008
Last Update Date: 04/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1959 NE PACIFIC ST # B242
SEATTLE WA
98195-0001
US

IV. Provider business mailing address

4800 SAND POINT WAY NE
SEATTLE WA
98105-3901
US

V. Phone/Fax

Practice location:
  • Phone: 206-543-4885
  • Fax: 206-616-7470
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberDF60003906
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: