Provider Demographics
NPI:1053867986
Name:JASON L HILDE DDS PLLC
Entity Type:Organization
Organization Name:JASON L HILDE DDS PLLC
Other - Org Name:HILDE FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:L
Authorized Official - Last Name:HILDE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:360-707-5353
Mailing Address - Street 1:120 E GEORGE HOPPER RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:BURLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98233-3125
Mailing Address - Country:US
Mailing Address - Phone:360-707-5353
Mailing Address - Fax:360-707-5343
Practice Address - Street 1:120 E GEORGE HOPPER RD
Practice Address - Street 2:SUITE 210
Practice Address - City:BURLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98233-3125
Practice Address - Country:US
Practice Address - Phone:360-707-5353
Practice Address - Fax:360-707-5343
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-31
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000084411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty