MEDICARE: SEA MAR SPECIALTY DENTAL GROUP

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	152W00000X	Optometrist
2	207RG0100X	Gastroenterology Physician
3	207RR0500X	Rheumatology Physician
4	207RS0010X	Sports Medicine (Internal Medicine) Physician
5	261QD0000X	Dental Clinic/Center
6	261QS0112X	Oral and Maxillofacial Surgery Clinic/Center
7	174400000X	Specialist

General Provider Information

NPI Number	:	1568981470
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SEA MAR SPECIALTY DENTAL GROUP

Provider Business Mailing Address
First Line	:	1040 S HENDERSON ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98108-4720
Country	:	US
Telephone Number	:	206-763-5277
Fax Number	:

Provider Business Practice Location Address
First Line	:	2000 116TH AVE NE
Second Line	:
City	:	BELLEVUE
State	:	WA
Zip	:	98004-3047
Country	:	US
Telephone Number	:	425-998-5090
Fax Number	:	425-998-5099

Authorized Official
Title or Position	:	ADMINISTRATION DIRECTOR
Name	:	KRISTINA HOESCHEN
Credential	:	DO
Telephone Number	:	206-763-5277

Provider Enumeration Date	:	09/12/2017
Last Update Date	:	03/17/2018

Similar Medicare Providers

1346235173 — DAVID P POMEROY MD PS
Practice Location Address:

2000 116TH AVE NE , STE 6
BELLEVUE, WA
98004-3047

Practice Phone: 425-454-8684
Practice Fax:

1124175252 — DR. WEI CHEN
Practice Location Address:

2000 116TH AVE NE STE 1B
BELLEVUE, WA
98004-3047

Practice Phone: 425-709-2436
Practice Fax: 425-709-2436

1679766323 — MR. PETER KAM-HO WONG M.S.
Practice Location Address:

2000 116TH AVE NE , SUITE 3
BELLEVUE, WA
98004-3047

Practice Phone: 206-356-3233
Practice Fax:

1760701528 — DR. DAVID PHIPPS POMEROY M.D.
Practice Location Address:

2000 116TH AVE NE STE 6
BELLEVUE, WA
98004-3047

Practice Phone: 425-454-8684
Practice Fax: 206-339-5465

1942665831 — SEA MAR COMMUNITY HEALTH CENTERS
Practice Location Address:

2000 116TH AVE NE
BELLEVUE, WA
98004-3047

Practice Phone: 425-998-5090
Practice Fax: 425-998-5099

1275554446 — DR. JOEL R WILSON MD
Practice Location Address:

1135-116TH AVENUE NE
BELLEVUE, WA
98004

Practice Phone: 425-454-2656
Practice Fax: 425-455-2620

Directions to “SEA MAR SPECIALTY DENTAL GROUP ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.