MINH DAU, DDS AND RAYMOND PARK, DDS PLLC (NPI# 1831624402) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831624402 |
| Entity Type | Organization |
| Organization Name | MINH DAU, DDS AND RAYMOND PARK, DDS PLLC |
| Practice Address |
3105 Alderwood Mall Blvd Suite 117 Lynnwood WA 98036-4703 |
| Practice Telephone | 4252849886 |
| Mailing Telephone | 4252849886 |
| Enumeration Date | 2017-04-20 |
| Last Update Date | 2017-04-20 |
| Authorized Official Name | RAYMOND PARK (GOVERNOR) |
| Authorized Official Telephone | 4252849886 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
DE60467195 | WA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 1861743205 | 05 | |
| WA | 1548521248 | 05 |
| Street Address |
3105 ALDERWOOD MALL BLVD SUITE 117 |
| City | LYNNWOOD |
| State | WA |
| Zip Code | 98036-4703 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396342630 | Zachary Perry | Behavior Technician | 4100 Veterans Way, Unit 100, Lynnwood, WA 98036 | 2020-10-08 |
| 1942832795 | Alexis Michelle Solomon-winne | Behavior Technician | 4100 Veterans Way Unit 100 Lynnwood, Wa 98036 United S, Lynnwood, WA 98036 | 2020-02-10 |
| 1881239028 | Endc Pllc | Psychologist | 19217 36th Ave W. Suite 219, Lynnwood, WA 98036 | 2019-11-12 |
| 1225507866 | Kyung Suk Seo | Massage Therapist | 18904 Hwy 99, Ste. K, Lynnwood, WA 98036 | 2018-11-13 |
| 1790270197 | Kabal Sriviboon | Behavior Technician | 20818 44th Ave W Suite 270, Lynnwood, WA 98036 | 2018-06-27 |
| 1992206148 | Kendal Ilyse Borison | Behavioral Analyst | 4100 194th Se, Suite 100, Lynnwood, WA 98036 | 2018-02-23 |
| 1205352515 | Doug Brant | Registered Nurse | 19931 Cypress Way, Lynnwood, WA 98036 | 2017-08-17 |
| 1588184980 | Evergreen Recovery Centers-lynnwood Detox | Substance Abuse Rehabilitation Facility | 20508 56th Ave W, Lynnwood, WA 98036 | 2017-06-27 |
| 1699213439 | Patrick J. Pacyga | Dentist | 19620 Wa-99, Suite 106, Lynnwood, WA 98036 | 2017-02-01 |
| 1134676646 | Fiona Green | Occupational Therapy Assistant | 21503 8th Place W, A, Lynnwood, WA 98036 | 2016-09-01 |
| Find all providers in zip 98036 | ||||
| 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 |
|---|---|---|---|---|
| 1548656929 | Kate Suzanne Goldberg | Dentist | 18833 28th Ave W Ste B, Lynnwood, WA 98036 | 2015-04-12 |
| 1548521248 | Raymond B Park | Dentist | 3105 Alderwood Mall Blvd Ste 117, Lynnwood, WA 98036-4745 | 2012-05-30 |
| 1427211432 | Roger W Lucas | Dentist | 18833 28th Ave W., Suite B, Lynnwood, WA 98036 | 2008-07-09 |
| 1184796286 | Norman J Bunch | Dentist | 20102 Cedar Valley Rd Ste 105, Lynnwood, WA 98036-6333 | 2006-11-14 |
| 1932219482 | John A. Churchill | Dentist | 19106 33rd Ave W Ste 1, Lynnwood, WA 98036-4712 | 2006-08-30 |
| 1366802662 | Kim & Chung, Dds, Pllc | Dentist | 16006 Ash Way, Ste 103, Lynnwood, WA 98087-6352 | 2016-02-29 |
| 1235510512 | Nicholas Andrew Raklios | Dentist | 16006 Ash Way, Ste 103, Lynnwood, WA 98087-6352 | 2015-06-12 |
| 1053633495 | Everyone By One - Lynnwood Pllc | Dentist | 16006 Ash Way, Suite 103, Lynnwood, WA 98087-6352 | 2010-02-26 |
| 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 |
| 1497248017 | Jinju Song Dmd Pllc | Dentist | 9707 Ne 119th Way, Kirkland, WA 98034-8955 | 2018-06-08 |
| 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 |
| 1306370572 | Sonu Lamba and Paul S Kahlon, Ps | Dentist | 13209 44th Ave Se, Mill Creek, WA 98012-8985 | 2017-04-14 |
| Find all providers with the same taxonomy | ||||
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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.