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General NPI Number Information
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NPI Number | 1568332682
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Entity Type | Organization
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Legal Business Name | M ETEMADI DMD PLLC
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Dates
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Enumeration Date | 11/05/2025
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Last Update Date | 11/05/2025
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Provider Practice Location Address
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Address Line | 2121 MADISON ST STE A
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City | EVERETT
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State | WA
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Zip | 98203-5375
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Country | US
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Telephone | 425-353-5854
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Fax |
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Provider Business Mailing Address
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Address Line | 18713 136TH AVE NE
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City | WOODINVILLE
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State | WA
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Zip | 98072-5732
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | MASSIH ETEMADI
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Credential | DMD
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Telephone | 425-548-4499
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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