=====================================================
General NPI Number Information
=====================================================
NPI Number | 1285851006
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | STEVEN C. ALEINIKOFF, DDS & CRAIG M. TIMBERLAKE, DDS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/20/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4522 15TH AVE NE
-----------------------------------------------------
City | SEATTLE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98105-4507
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-523-2025
-----------------------------------------------------
Fax | 206-525-6956
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4522 15TH AVE NE
-----------------------------------------------------
City | SEATTLE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98105-4507
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-523-2025
-----------------------------------------------------
Fax | 206-525-6956
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DENTIST
-----------------------------------------------------
Name | STEVEN C. ALEINIKOFF
-----------------------------------------------------
Credential | D.D.S
-----------------------------------------------------
Telephone | 206-523-2025
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------