MEDICARE: GLENN J YORITA DDS, MS

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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry

General Provider Information

NPI Number	:	1710825641
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GLENN J YORITA DDS, MS

Provider Business Mailing Address
First Line	:	465 RAINIER BLVD N STE B
Second Line	:
City	:	ISSAQUAH
State	:	WA
Zip	:	98027-2826
Country	:	US
Telephone Number	:	425-391-1814
Fax Number	:	425-837-9233

Provider Business Practice Location Address
First Line	:	465 RAINIER BLVD N STE B
Second Line	:
City	:	ISSAQUAH
State	:	WA
Zip	:	98027-2826
Country	:	US
Telephone Number	:	425-391-1814
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. GLENN J YORITA
Credential	:	DDS, MS
Telephone Number	:	425-391-1814

Provider Enumeration Date	:	03/23/2026
Last Update Date	:	03/23/2026

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