| Juanita Kids Dentistry | |
|
9707 Ne 119th Way Kirkland WA 98034-8955 | |
| (425) 310-8338 | |
| (425) 449-5933 |
| Full Name | Juanita Kids Dentistry |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 9707 Ne 119th Way, Kirkland, Washington |
| Authorized Official Name and Position | Jinju Song (OWNER/DOCTOR) |
| Authorized Official Contact | 4253108338 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Juanita Kids Dentistry 9707 Ne 119th Way Kirkland WA 98034-8955 Ph: (425) 310-8338 | Juanita Kids Dentistry 9707 Ne 119th Way Kirkland WA 98034-8955 Ph: (425) 310-8338 |
| NPI Number | 1497248017 |
|---|---|
| Provider Enumeration Date | 06/08/2018 |
| Last Update Date | 06/08/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497248017 | NPI | - | NPPES |
| 1255644316 | Other | INDIVIDUAL NPI | |
| DE60300517 | Other | WA | LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | DE60300517 (Washington) | Primary |
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