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General NPI Number Information
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NPI Number | 1881974285
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Entity Type | Organization
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Legal Business Name | STRAIGHT PEARLS ORTHODONTICS PLLC
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Dates
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Enumeration Date | 08/17/2011
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Last Update Date | 08/17/2011
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Provider Practice Location Address
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Address Line | 6720 FORT DENT WAY SUITE 120
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City | TUKWILA
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State | WA
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Zip | 98188-8508
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Country | US
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Telephone | 425-802-7100
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Fax |
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Provider Business Mailing Address
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Address Line | 17000 140TH AVE NE SUITE 204
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City | WOODINVILLE
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State | WA
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Zip | 98072-6928
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Country | US
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Telephone | 425-802-7100
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Fax | 425-481-9493
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Authorized Official
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Title or Position | OWNER
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Name | DR. MAJED MOAWAD
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Credential | D.M.D.
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Telephone | 425-802-7100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DE8207
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DE8207
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License Number State | WA
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