MEDICARE: JAMES LOVELACE PLLC

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	1223P0300X	Periodontics

General Provider Information

NPI Number	:	1336005099
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JAMES LOVELACE PLLC

Provider Business Mailing Address
First Line	:	3402 173RD PL NE STE 203
Second Line	:
City	:	ARLINGTON
State	:	WA
Zip	:	98223-8497
Country	:	US
Telephone Number	:	360-598-2172
Fax Number	:	360-322-3909

Provider Business Practice Location Address
First Line	:	3402 173RD PL NE STE 203
Second Line	:
City	:	ARLINGTON
State	:	WA
Zip	:	98223-8497
Country	:	US
Telephone Number	:	360-598-2172
Fax Number	:	360-322-3909

Authorized Official
Title or Position	:	PERIODONTIST / OWNER
Name	:	JAMES LOVELACE
Credential	:	DDS MSD
Telephone Number	:	360-598-2172

Provider Enumeration Date	:	12/26/2025
Last Update Date	:	12/26/2025

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