Provider Demographics
NPI:1861290553
Name:JOSEPH EIDSNESS, DDS, PLLC
Entity type:Organization
Organization Name:JOSEPH EIDSNESS, DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:R
Authorized Official - Last Name:EIDSNESS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:360-618-2877
Mailing Address - Street 1:5430 91ST ST NE
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98270-2642
Mailing Address - Country:US
Mailing Address - Phone:360-618-2877
Mailing Address - Fax:
Practice Address - Street 1:7209 265TH ST NW STE 201
Practice Address - Street 2:
Practice Address - City:STANWOOD
Practice Address - State:WA
Practice Address - Zip Code:98292-6292
Practice Address - Country:US
Practice Address - Phone:360-629-3133
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-06
Last Update Date:2025-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental