Healthcare Provider Details

I. General information

NPI: 1912526062
Provider Name (Legal Business Name): CHRISTOPHER JOHN CONSER DDS, MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2020
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4722 FAUNTLEROY WAY SW STE A
SEATTLE WA
98116-4667
US

IV. Provider business mailing address

4722 FAUNTLEROY WAY SW STE A
SEATTLE WA
98116-4667
US

V. Phone/Fax

Practice location:
  • Phone: 206-928-6242
  • Fax:
Mailing address:
  • Phone: 206-928-6242
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberDENT.DE.70139312
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: