MEDICARE: DR. ANDREW J TELLINGTON D.M.D

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	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	DE60426234	WA

General Provider Information

NPI Number	:	1174717524
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREW J TELLINGTON D.M.D

Provider Business Mailing Address
First Line	:	10855 SILVERDALE WAY NW UNIT 1460
Second Line	:
City	:	SILVERDALE
State	:	WA
Zip	:	98383-9827
Country	:	US
Telephone Number	:	360-895-8841
Fax Number	:	360-895-9350

Provider Business Practice Location Address
First Line	:	2040 MITCHELL RD SE
Second Line	:
City	:	PORT ORCHARD
State	:	WA
Zip	:	98366-4401
Country	:	US
Telephone Number	:	360-895-8841
Fax Number	:	360-895-9350

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

Provider Enumeration Date	:	08/29/2007
Last Update Date	:	03/31/2026

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1942802301 — ANDREW J. TELLINGTON DMD, P.C.
Practice Location Address:

2040 MITCHELL RD SE
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1255271789 — MARY KARANJA
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