Provider Demographics
NPI:1033941661
Name:INTELLIGENT DENTISTRY PLLC
Entity type:Organization
Organization Name:INTELLIGENT DENTISTRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SOFIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:DZHALOVSKIY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-280-2237
Mailing Address - Street 1:14535 NE BEL RED RD STE 101B
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98007-3907
Mailing Address - Country:US
Mailing Address - Phone:425-300-1239
Mailing Address - Fax:
Practice Address - Street 1:14535 NE BEL RED RD STE 101B
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007-3907
Practice Address - Country:US
Practice Address - Phone:425-300-1239
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-14
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty