MEDICARE: BELLEVUE SPECIALIZED DENTAL CARE

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	261QD0000X	Dental Clinic/Center	DE00008824	WA

General Provider Information

NPI Number	:	1114037108
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BELLEVUE SPECIALIZED DENTAL CARE

Provider Business Mailing Address
First Line	:	15700 BEL RED RD
Second Line	:
City	:	BELLEVUE
State	:	WA
Zip	:	98008-2231
Country	:	US
Telephone Number	:	425-881-8448
Fax Number	:	425-881-0355

Provider Business Practice Location Address
First Line	:	15700 BEL RED RD
Second Line	:
City	:	BELLEVUE
State	:	WA
Zip	:	98008-2231
Country	:	US
Telephone Number	:	425-881-8448
Fax Number	:	425-881-0355

Authorized Official
Title or Position	:	OWNER
Name	:	DR. DAVID ARONOWITZ
Credential	:	DDS, MSD
Telephone Number	:	425-881-8448

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	08/22/2020

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