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General NPI Number Information
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NPI Number | 1528996725
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Entity Type | Organization
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Legal Business Name | DKEIDEK PLLC
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Dates
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Enumeration Date | 05/11/2026
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Last Update Date | 05/11/2026
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Provider Practice Location Address
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Address Line | 21807 76TH AVE W STE 1
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City | EDMONDS
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State | WA
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Zip | 98026-7938
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Country | US
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Telephone | 425-775-2002
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Fax |
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Provider Business Mailing Address
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Address Line | 21807 76TH AVE W STE 1
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City | EDMONDS
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State | WA
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Zip | 98026-7938
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Country | US
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Telephone | 425-775-2002
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ISSA DKEIDEK
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Credential | DDS MSD
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Telephone | 716-713-2613
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State |
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