Provider Demographics
NPI:1033418868
Name:KEVIN D BIEDERMAN DDS PLLC
Entity Type:Organization
Organization Name:KEVIN D BIEDERMAN DDS PLLC
Other - Org Name:BIEDERMAN DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BIEDERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-552-5287
Mailing Address - Street 1:7900 E GREEN LAKE DR N
Mailing Address - Street 2:STE 300
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-4800
Mailing Address - Country:US
Mailing Address - Phone:206-552-5287
Mailing Address - Fax:
Practice Address - Street 1:7900 E GREEN LAKE DR N
Practice Address - Street 2:STE 300
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-4800
Practice Address - Country:US
Practice Address - Phone:206-552-5287
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-18
Last Update Date:2011-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE00010228122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty