=====================================================
General NPI Number Information
=====================================================
NPI Number | 1457203945
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MARK BREINHOLT DDS PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/10/2026
-----------------------------------------------------
Last Update Date | 02/10/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3400 SQUALICUM PKWY STE 103
-----------------------------------------------------
City | BELLINGHAM
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98225-1933
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 360-734-6728
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3400 SQUALICUM PKWY STE 103
-----------------------------------------------------
City | BELLINGHAM
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98225-1933
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 360-734-6728
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DENTIST
-----------------------------------------------------
Name | DR. MARK ROBERT BREINHOLT
-----------------------------------------------------
Credential | DDS
-----------------------------------------------------
Telephone | 360-734-6728
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QD0000X
-----------------------------------------------------
Taxonomy Name | Dental Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------