Provider Demographics
NPI:1730863317
Name:PARKINSON, STEFANIE (DDS)
Entity type:Individual
Prefix:DR
First Name:STEFANIE
Middle Name:
Last Name:PARKINSON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3525 239TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:SAMMAMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98029-7561
Mailing Address - Country:US
Mailing Address - Phone:425-941-4227
Mailing Address - Fax:
Practice Address - Street 1:32114 1ST AVE S STE 101
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-5760
Practice Address - Country:US
Practice Address - Phone:425-227-3368
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE61445530122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist