Provider Demographics
NPI:1003844770
Name:ESPINOZA, KIMBERLY MARIE (DDS)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:MARIE
Last Name:ESPINOZA
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:UNIVERSITY OF WASHINGTON SCHOOL OF DENTISTRY
Mailing Address - Street 2:BOX 356370
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98195-6370
Mailing Address - Country:US
Mailing Address - Phone:206-543-6501
Mailing Address - Fax:206-685-8412
Practice Address - Street 1:1959 NE PACIFIC ST
Practice Address - Street 2:BOX 356370
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195-6370
Practice Address - Country:US
Practice Address - Phone:206-543-6501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2014-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMTD0014122300000X
WADEFC.DF.60476251122300000X
NMDD3166122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist