Provider Demographics
NPI:1548331796
Name:HERRIN, HILTON DEE (DDS)
Entity type:Individual
Prefix:
First Name:HILTON
Middle Name:DEE
Last Name:HERRIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3255 CALIFORNIA AVE SW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98116-3304
Mailing Address - Country:US
Mailing Address - Phone:206-935-0100
Mailing Address - Fax:206-935-1300
Practice Address - Street 1:3255 CALIFORNIA AVE SW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98116-3304
Practice Address - Country:US
Practice Address - Phone:206-935-0100
Practice Address - Fax:206-935-1300
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE00006047122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist