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General NPI Number Information
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NPI Number | 1932229168
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Entity Type | Organization
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Legal Business Name | RUSSELL K. NOMI, DDS, PS
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Dates
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Enumeration Date | 03/30/2007
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Last Update Date | 06/16/2008
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Provider Practice Location Address
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Address Line | 6507 132ND AVE NE
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City | KIRKLAND
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State | WA
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Zip | 98033-8628
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Country | US
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Telephone | 425-881-9333
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Fax | 425-881-2333
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Provider Business Mailing Address
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Address Line | 6507 132ND AVE NE
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City | KIRKLAND
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State | WA
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Zip | 98033-8628
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Country | US
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Telephone | 425-881-9333
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Fax | 425-881-2333
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Authorized Official
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Title or Position | DENTIST
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Name | DR. RUSSELL K NOMI
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Credential | DDS
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Telephone | 425-881-9333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 5604
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License Number State | WA
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