Provider Demographics
NPI:1912862194
Name:DKEIDEK, FERNYHOUGH, GILE, HAGEL, NOV & QUICKSTAD PLLC
Entity type:Organization
Organization Name:DKEIDEK, FERNYHOUGH, GILE, HAGEL, NOV & QUICKSTAD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RDO
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCONKEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-559-5343
Mailing Address - Street 1:900 LENORA ST STE 216
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98121-2753
Mailing Address - Country:US
Mailing Address - Phone:206-402-5490
Mailing Address - Fax:
Practice Address - Street 1:900 LENORA ST STE 216
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98121-2753
Practice Address - Country:US
Practice Address - Phone:206-402-5490
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-12-18
Last Update Date:2025-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty