KIRKLAND KIDS DENTISTRY (NPI# 1306225511) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306225511 |
| Entity Type | Organization |
| Organization Name | KIRKLAND KIDS DENTISTRY |
| Practice Address |
13118 121st Way Ne Suite 103 Kirkland WA 98034-3004 |
| Practice Telephone | 7167254676 |
| Mailing Telephone | 7167254676 |
| Enumeration Date | 2015-05-20 |
| Last Update Date | 2015-05-20 |
| Authorized Official Name | ALLYSON STEWART DKEIDEK (PEDIATRIC DENTIST) |
| Authorized Official Telephone | 7167254676 |
| Authorized Official Credential | D.D.S. CERT. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
60124299 | WA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 2008604 | 05 |
| Street Address |
13118 121ST WAY NE SUITE 103 |
| City | KIRKLAND |
| State | WA |
| Zip Code | 98034-3004 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942239413 | Edward Courtright La Cava | Internal Medicine | 13118 121st Way Ne, Suite 103, Kirkland, WA 98034-3004 | 2006-06-30 |
| 1376073130 | Marisha Noelle Lewis | Physical Therapy Assistant | 13118 121st Way Ne, Suite 201, Kirkland, WA 98034-3004 | 2017-06-14 |
| 1578837845 | Kendra L Alkire | Physical Therapist | 13118 121st Way Ne, Suite 201, Kirkland, WA 98034-3004 | 2012-03-02 |
| 1083827927 | Wenzhen Jin | Acupuncturist | 13118 121st Way Ne, Suite 100, Kirkland, WA 98034-3004 | 2007-05-08 |
| 1831316074 | Pina Shah Mehta | Physical Therapist | 13118 121st Way Ne, Suite 201, Kirkland, WA 98034-3004 | 2007-04-19 |
| 1043433394 | Loretta O Marx | Physical Therapist | 13118 121st Way Ne, Suite 201, Kirkland, WA 98034-3004 | 2007-04-11 |
| 1194948455 | Gordon E Marx | Physical Therapist | 13118 121st Way Ne, Suite 201, Kirkland, WA 98034-3004 | 2007-04-11 |
| 1982827234 | Kory K Takamura | Physical Therapist | 13118 121st Way Ne, Suite 201, Kirkland, WA 98034-3004 | 2007-04-11 |
| 1639392905 | Kirkland Physical Therapy, Inc., P.s. | Physical Therapist | 13118 121st Way Ne, Suite 201, Kirkland, WA 98034-3004 | 2007-04-11 |
| 1093813800 | Philip J Etheredge | Dentist | 13118 121st Way Ne, Suite 102, Kirkland, WA 98034 | 2006-09-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578116596 | Rachel Bowers | Behavior Technician | 1335 Northeast 122nd Way, Suite 105, Kirkland, WA 98034 | 2019-07-18 |
| 1740841048 | Kristina Louise Inghram | Behavior Technician | 11415 Ne 128th St., Suite 40, Kirkland, WA 98034 | 2019-06-26 |
| 1053978064 | Matthew A. Bagnulo, Dds, Ps | Dentist | 11830 Ne 128th St., #202, Kirkland, WA 98034 | 2019-05-24 |
| 1629568928 | Stephanie Michalko | Optometrist | 11800 Ne 128th St Ste 110, Kirkland, WA 98034 | 2018-05-14 |
| 1952800013 | Heath Family Counseling LLC | Marriage & Family Therapist | 12025 115th Ave. Ne, Building D, Ste 200, Kirkland, WA 98034 | 2018-02-05 |
| 1891202834 | Barbara Josephine Gorham | Counselor | 2025 115th Ave Ne, Bldg D, #200, Kirkland, WA 98034 | 2017-12-29 |
| 1548782915 | Eleanor Hollis Wall | Counselor | 14340 102nd Ave Ne, Kirkland, WA 98034 | 2017-07-07 |
| 1457885212 | Peter Schoonmaker | Hospitalist | 12040 Ne 128th Street, Ms105, Kirkland, WA 98034 | 2017-04-18 |
| 1780124370 | Rebecca Managan | Advanced Practice Midwife | 12303 Ne 130th Ln Ste Coral225, Kirkland, WA 98034 | 2017-03-01 |
| 1669821104 | Winter Gonzalez | Counselor | 11720 97th Ln Ne Apt A411, Kirkland, WA 98034 | 2016-06-06 |
| Find all providers in zip 98034 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497248017 | Jinju Song Dmd Pllc | Dentist | 9707 Ne 119th Way, Kirkland, WA 98034-8955 | 2018-06-08 |
| 1255644316 | Jinju Song | Dentist | 12410 87th Ct Ne, Kirkland, WA 98034-6033 | 2010-07-19 |
| 1265495196 | Susan Kim Dds | Dentist | 12910 Totem Lake Blvd Ne Ste 103, Kirkland, WA 98034 | 2006-04-11 |
| 1174881759 | Aimee Kong Dds Pllc | Dentist | 620 Kirkland Way, Suite 102, Kirkland, WA 98033-6021 | 2012-05-02 |
| 1982910410 | Aimee L Kong | Dentist | 620 Kirkland Way, Suite 102, Kirkland, WA 98033-6021 | 2010-08-22 |
| 1871652032 | Clinton Thomas Worton | Dentist | 620 Kirkland Way, Suite 102, Kirkland, WA 98033-6021 | 2006-12-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740807890 | Plateau Kids Dentistry, LLC | Dentist | 2912 228th Ave Se Ste A, Sammamish, WA 98075-9305 | 2020-07-05 |
| 1528603503 | Ellen Polsky Dds and Bobby Virk Dmd, Ps | Dentist | 34704 11th Pl S Ste 101, Federal Way, WA 98003-8730 | 2019-11-13 |
| 1942843552 | Laura Stewart Dds Pllc | Dentist | 6821 Ne 181st St, Kenmore, WA 98028-5034 | 2019-10-26 |
| 1639736119 | Southcenter Children's Dentistry | Dentist | 411 Strander Blvd Ste 303, Tukwila, WA 98188-2924 | 2019-05-21 |
| 1770147001 | Kaitlin Neste Pllc | Dentist | 360 Tormey Ln Ne Ste 198, Bainbridge Island, WA 98110-1990 | 2019-04-22 |
| 1124511126 | Roger Lucas, P.s. | Dentist | 3806 116th St. Ne, Marysville, WA 98271 | 2018-06-13 |
| 1861999864 | Peter Douglas | Dentist | 32105 1st Ave S Ste B3, Federal Way, WA 98003-5719 | 2018-04-07 |
| 1669994042 | Annikka Louise Frostad-thomas | Dentist | 700 Nw Gilman Blvd # E412, Issaquah, WA 98027-5395 | 2017-07-07 |
| 1831624402 | Minh Dau, Dds and Raymond Park, Dds Pllc | Dentist | 3105 Alderwood Mall Blvd, Suite 117, Lynnwood, WA 98036-4703 | 2017-04-20 |
| 1306370572 | Sonu Lamba and Paul S Kahlon, Ps | Dentist | 13209 44th Ave Se, Mill Creek, WA 98012-8985 | 2017-04-14 |
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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.