| |
22620 Se 4th St Ste 210 Sammamish WA 98074-7375 | |
(425) 526-2060 | |
Not Available |
Full Name | |
---|---|
Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
Location | 22620 Se 4th St Ste 210, Sammamish, Washington |
Authorized Official Name and Position | Roozbeh Khosravi (ORTHODONTIST) |
Authorized Official Contact | 6174669090 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
22620 Se 4th St Ste 210 Sammamish WA 98074-7375 Ph: (425) 526-2060 | 22620 Se 4th St Ste 210 Sammamish WA 98074-7375 Ph: (425) 526-2060 |
NPI Number | 1962913509 |
---|---|
Provider Enumeration Date | 10/23/2017 |
Last Update Date | 10/23/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1962913509 | NPI | - | NPPES |
1629433891 | Medicaid | WA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Primary |
Rhonda Newton Dds Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 707 228th Ave Ne, Sammamish, WA 98074 Phone: 425-868-0123 Fax: 425-868-0714 | |