| Newport Dental | |
|
12826 Se 40th Ln Ste 201 Bellevue WA 98006-4276 | |
| (425) 641-5303 | |
| Not Available |
| Full Name | Newport Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 12826 Se 40th Ln Ste 201, Bellevue, Washington |
| Authorized Official Name and Position | Yong K Park (DDS) |
| Authorized Official Contact | 4256415303 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Newport Dental 12826 Se 40th Ln Ste 201 Bellevue WA 98006-4276 Ph: () - | Newport Dental 12826 Se 40th Ln Ste 201 Bellevue WA 98006-4276 Ph: (425) 641-5303 |
| NPI Number | 1801110861 |
|---|---|
| Provider Enumeration Date | 03/19/2010 |
| Last Update Date | 03/19/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801110861 | NPI | - | NPPES |
| 5055389 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DE0009186 (Washington) | Primary |
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