Provider Demographics
NPI:1003927245
Name:JOHN C LIND DDS
Entity Type:Organization
Organization Name:JOHN C LIND DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DDS
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:CHURCH
Authorized Official - Last Name:LIND
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:206-232-5866
Mailing Address - Street 1:3236 78TH AVE SE
Mailing Address - Street 2:SUITE 106
Mailing Address - City:MERCER ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98040
Mailing Address - Country:US
Mailing Address - Phone:206-232-5866
Mailing Address - Fax:206-232-5870
Practice Address - Street 1:3236 78TH AVE SE
Practice Address - Street 2:SUITE 106
Practice Address - City:MERCER ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98040
Practice Address - Country:US
Practice Address - Phone:206-232-5866
Practice Address - Fax:206-232-5870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA24211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty