DA VINCI DENTAL LLC (NPI# 1619350857) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619350857 |
| Entity Type | Organization |
| Organization Name | DA VINCI DENTAL LLC |
| Other Organization Name | KALM DENTAL SPA |
| Practice Address |
909 112th Ave Ne Suite P-104 Bellevue WA 98004-8580 |
| Practice Telephone | 4254099999 |
| Practice Fax Number | 8885075181 |
| Mailing Telephone | 4254099999 |
| Mailing Fax Number | 8885075181 |
| Enumeration Date | 2015-07-07 |
| Last Update Date | 2015-07-07 |
| Authorized Official Name | DR. BEAU J KELLER (OWNER) |
| Authorized Official Telephone | 4257602704 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | Y |
| Parent Organization Name | DA VINCI DENTAL LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | D009161 | AZ | Dental Providers |
| Y | 122300000X | Dentist | DE00011082 | WA | Dental Providers |
| Other Name | Type Code |
|---|---|
| KALM Dental Spa | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346628203 | Da Vinci Dental LLC | Dentist | 7014 E Camelback Rd, Suite 2145, Scottsdale, AZ 85251-1227 | 2015-05-12 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | DA VINCI DENTAL LLC | 909 112th Ave Ne, Suite# P-104, Bellevue, WA 98004-8589 |
| Street Address |
909 112TH AVE NE SUITE P-104 |
| City | BELLEVUE |
| State | WA |
| Zip Code | 98004-8580 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588856652 | Beau J Keller | Dentist | 909 112th Ave Ne, Suite P-104, Bellevue, WA 98004-8580 | 2007-08-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306458328 | Geneva Paula Hoskins-dorsey | Nurse Practitioner | 11120 Ne 33rd Place, Suite 202, Bellevue, WA 98004 | 2020-08-20 |
| 1720553613 | Christine Eyler | Pediatrics | Bellevue Pediatrics, C & C Medical Associates, 1940 116th Ave Ne, Ste 200, Bellevue, WA 98004 | 2018-10-08 |
| 1437634730 | Hazelden Betty Ford Foundation | Clinic/Center | 1231 116th Ave. Ne Suite 410, Bellevue, WA 98004 | 2018-10-02 |
| 1356827828 | Seattle Spine Group, Pllc | Orthopaedic Surgery | 1220 116th Ave Ne Ste 102, Bellevue, WA 98004 | 2018-07-17 |
| 1669989216 | Atsuko Nakajima | Acupuncturist | 2223 112th Ave. Ne, Ste 201, Bellevue, WA 98004 | 2018-01-04 |
| 1740794718 | Radka Chapin Counseling, LLC | Clinic/Center | 1611 116th Ave Ne Ste 119, Bellevue, WA 98004 | 2017-11-28 |
| 1962912105 | Cuyler Ann Simmons | Counselor | 3805 108th Ave Ne Ste 204, Bellevue, WA 98004 | 2017-10-02 |
| 1639690357 | Nicolas Lopez-montalvo | Behavioral Analyst | 3003 Northup Way Suite 200, Bellevue, WA 98004 | 2017-07-03 |
| 1124579537 | Matthew Thomas Haley | Pharmacist | 107 Bellevue Way, Se, Bellevue, WA 98004 | 2016-10-20 |
| 1649727348 | Kelsey Tanaka | Nurse Practitioner | 400- 108th Ave Ne, Suite 100, Bellevue, WA 98004 | 2016-09-10 |
| Find all providers in zip 98004 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174121966 | Brandon C Hahn | Dentist | 6574 153rd Ave Se, Bellevue, WA 98006-5424 | 2020-10-13 |
| 1568069391 | Neha Agarwal | Dentist | 13605 Ne 10th Pl # 8-101, Bellevue, WA 98005-2743 | 2020-10-05 |
| 1821609710 | Chaeli Ford | Dentist | 3672 Lexington Ave, Bellevue, NE 68123-1321 | 2020-08-13 |
| 1154949097 | Karanjot Singh Bath | Dentist | 15938 Ne 15th St, Bellevue, WA 98008-2707 | 2020-07-08 |
| 1457902595 | Washington Dental Corporation, PC | Dentist | 2235 148th Ave Ne, Bellevue, WA 98007-3726 | 2019-09-20 |
| 1053892406 | Frank Charles Hokhold | Dentist | 123 112th Ave Ne Apt 442, Bellevue, WA 98004-6497 | 2018-08-23 |
| 1902312168 | Priyanka Sharma | Dentist | 10500 Ne 8th St Ste 208, Bellevue, WA 98004-4351 | 2017-12-22 |
| 1235644899 | Kwang Jin Hahn | Dentist | 14215 Se 44th St, Bellevue, WA 98006-2335 | 2017-12-05 |
| 1710402235 | Jun Eon Weaver | Dentist | 700 140th Ave Se, Bellevue, WA 98005-3726 | 2017-08-04 |
| 1801324389 | Kelsey M Sasse | Dentist | 3615 Summit Plaza Dr Ste 101, Bellevue, NE 68123-1088 | 2017-05-30 |
| Find all providers in BELLEVUE | ||||
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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.