MEDICARE: NORTH SEATTLE PERIODONTICS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	122300000X	Dentist
2	1223P0700X	Prosthodontics
3	1223P0300X	Periodontics

General Provider Information

NPI Number	:	1013865070
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTH SEATTLE PERIODONTICS

Provider Business Mailing Address
First Line	:	1222 N 185TH ST STE 102
Second Line	:
City	:	SHORELINE
State	:	WA
Zip	:	98133-4034
Country	:	US
Telephone Number	:	206-953-5799
Fax Number	:	206-546-2821

Provider Business Practice Location Address
First Line	:	1222 N 185TH ST STE 102
Second Line	:
City	:	SHORELINE
State	:	WA
Zip	:	98133-4034
Country	:	US
Telephone Number	:	206-953-5799
Fax Number	:	206-546-2821

Authorized Official
Title or Position	:	OWNER
Name	:	DR. KANAKO NAGATOMO
Credential	:	DDS, MSD, PHD
Telephone Number	:	206-953-5799

Provider Enumeration Date	:	03/17/2026
Last Update Date	:	03/17/2026

Similar Medicare Providers

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Directions to “NORTH SEATTLE PERIODONTICS ” Practice Location

Language	Start Address	Practice Location

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