LAKE SAMMAMISH FAMILY DENTISTRY (NPI# 1093036709) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093036709 |
| Entity Type | Organization |
| Organization Name | LAKE SAMMAMISH FAMILY DENTISTRY |
| Practice Address |
5712 E Lake Sammamish Pkwy Se Ste 108 Issaquah WA 98029-8943 |
| Practice Telephone | 4253923900 |
| Mailing Telephone | 4253923900 |
| Enumeration Date | 2010-06-16 |
| Last Update Date | 2010-06-16 |
| Authorized Official Name | ANNA LISIN (DENTIST) |
| Authorized Official Telephone | 4253923900 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
60065361 | WA | Dental Providers |
| Street Address |
5712 E LAKE SAMMAMISH PKWY SE STE 108 |
| City | ISSAQUAH |
| State | WA |
| Zip Code | 98029-8943 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669784914 | Sarah S. Wasson | Dentist | 5712 E Lake Sammamish Pkwy Se, Suite 108, Issaquah, WA 98029-8943 | 2010-07-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134730161 | Katelyn Creech | Counselor | 1505 16th Lane Ne, Apt 404 Building O, Issaquah, WA 98029 | 2020-08-13 |
| 1326695438 | M Shoaib Haider Siddiqui | Dentist | Issaquah Modern Dentistry, 1416 Highlands Drie Ne, Suite 120, Issaquah, WA 98029 | 2019-08-22 |
| 1053885061 | Rose Osborne | Registered Nurse | 4580 Klahanie Dr Se #181, Sammamish, WA 98029 | 2019-01-14 |
| 1598260960 | Caryn Crosbie | Behavior Technician | 22526 Se 64th Place, Building D Suite 210, Issaquah, WA 98029 | 2018-03-28 |
| 1194110908 | May Y. Mar | Family Medicine | 5708 E. Lake Sammamish Pkwy Se, Issaquah, WA 98029 | 2015-03-30 |
| 1659765816 | Eastside Social Skills Therapy LLC | Preferred Provider Organization | 5436 232nd Ave Se, Issaquah, WA 98029 | 2015-03-26 |
| 1649513946 | Linda Scoppettone Knodel | Registered Nurse | 5303 231 Ave. Se, Issaquah, WA 98029 | 2013-04-04 |
| 1720323116 | Morley Slutsky | Preventive Medicine | 4580 Klahanie Dr. S.e.,#125, Issaquah, WA 98029 | 2012-12-11 |
| 1619248820 | Silas Dickenson Dudley | Dentist | 2520 Ne Park Dr, Suite C, Issaquah, WA 98029 | 2012-01-19 |
| 1659641678 | Cynthia J Creel | Technician/Technologist | 4580 Klahanie Dr. Se, #332, Issaquah, WA 98029 | 2012-01-06 |
| Find all providers in zip 98029 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295367209 | Nitin Jaggi | Dentist | 5006 E Lake Sammamish Pkwy Se, Issaquah, WA 98029-9220 | 2020-02-07 |
| 1275011165 | Andrew Jacob Keith | Dentist | 1416 Highlands Dr Ne Ste 120, Issaquah, WA 98029-6240 | 2018-08-01 |
| 1902323553 | David Robert Primrose | Dentist | 600 Nw Gilman Blvd Ste B, Issaquah, WA 98027 | 2017-08-24 |
| 1871033316 | Gene Jason Wang | Dentist | 3707 Providence Point Dr Se Ste E, Issaquah, WA 98029-6216 | 2017-03-02 |
| 1821340001 | Andy C. A. Yu | Dentist | 22525 Se 64th Pl Ste 170, Issaquah, WA 98027 | 2012-10-11 |
| 1285937219 | Kari C. Woo | Dentist | 22619 Se 64th Pl Ste 110, Issaquah, WA 98027-5342 | 2010-12-14 |
| 1598078206 | Carrie Lynn Bohm | Dentist | 698 Bear Ridge Dr Nw, Issaquah, WA 98027-5605 | 2010-07-22 |
| 1407002017 | Sarah Goodin | Dentist | 837 Rainier Blvd N, Issaquah, WA 98027-2413 | 2008-08-14 |
| 1467678227 | Eun Hee Kim | Dentist | 1135 Nw Gilman Blvd Ste F5, Issaquah, WA 98027-5345 | 2007-04-18 |
| 1689795593 | D Nguyen, Dds, Ps | Dentist | 670 Nw Gilman Blvd Ste B3, Issaquah, WA 98027-2444 | 2007-04-02 |
| Find all providers in ISSAQUAH | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.