=====================================================
General NPI Number Information
=====================================================
NPI Number | 1720493265
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MILDA CHMIELIAUSKAITE D.M.D, M.P.H
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/24/2014
-----------------------------------------------------
Last Update Date | 11/18/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1959 NE PACIFIC ST # B221
-----------------------------------------------------
City | SEATTLE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98195-3804
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-685-2937
-----------------------------------------------------
Fax | 206-616-8577
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1959 NE PACIFIC ST BOX 357191
-----------------------------------------------------
City | SEATTLE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98195-0001
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-685-2937
-----------------------------------------------------
Fax | 206-616-8577
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 122300000X
-----------------------------------------------------
Taxonomy Name | Dentist
-----------------------------------------------------
License Number | DE61322400
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 125Q00000X
-----------------------------------------------------
Taxonomy Name | Oral Medicine Dentistry
-----------------------------------------------------
License Number | DE61322400
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------