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General NPI Number Information
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NPI Number | 1093505422
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Entity Type | Organization
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Legal Business Name | MINT KIDS DENTISTRY
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Dates
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Enumeration Date | 05/08/2025
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Last Update Date | 05/08/2025
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Provider Practice Location Address
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Address Line | 1500 145TH PL SE
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City | BELLEVUE
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State | WA
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Zip | 98007-5516
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Country | US
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Telephone | 425-321-0833
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Fax | 425-310-3772
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Provider Business Mailing Address
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Address Line | 2141 WASHINGTON ST STE 110
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City | FERNDALE
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State | WA
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Zip | 98248-9183
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Country | US
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Telephone | 360-441-3999
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | MATTHEW YEH
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Credential | BDS
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Telephone | 360-441-3999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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