MEDICARE: DR. LAURA SHIM DMD, MS

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	DE61543342	WA

General Provider Information

NPI Number	:	1083065635
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAURA SHIM DMD, MS

Provider Business Mailing Address
First Line	:	3300 W MCGRAW ST STE 210
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98199-3246
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3300 W MCGRAW ST STE 210
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98199
Country	:	US
Telephone Number	:	206-848-7222
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2016
Last Update Date	:	08/06/2025

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