MEDICARE: KEVIN D BIEDERMAN D.D.S.

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	1223G0001X	General Practice Dentistry	00010228	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336205640
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEVIN D BIEDERMAN D.D.S.

Provider Business Mailing Address
First Line	:	7900 E GREEN LAKE DR N STE 300
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98103-4819
Country	:	US
Telephone Number	:	206-859-2767
Fax Number	:	206-859-2768

Provider Business Practice Location Address
First Line	:	7900 E GREEN LAKE DR N STE 300
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98103-4819
Country	:	US
Telephone Number	:	951-203-9070
Fax Number	:

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

Provider Enumeration Date	:	12/29/2006
Last Update Date	:	05/08/2019

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