Provider Demographics
NPI:1003989955
Name:MEIDINGER, DENNIS LEE (DD,S, MS)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:LEE
Last Name:MEIDINGER
Suffix:
Gender:M
Credentials:DD,S, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6532 FAIRWAY AVE SE
Mailing Address - Street 2:
Mailing Address - City:SNOQUALMIE
Mailing Address - State:WA
Mailing Address - Zip Code:98065-9773
Mailing Address - Country:US
Mailing Address - Phone:425-396-5844
Mailing Address - Fax:
Practice Address - Street 1:1340 8TH ST NE
Practice Address - Street 2:SUITE 102
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002-4700
Practice Address - Country:US
Practice Address - Phone:253-939-0055
Practice Address - Fax:253-939-2294
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA000039701223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics