Provider Demographics
NPI:1073181616
Name:AL-BASSYIOUNI, DINA (DDS)
Entity Type:Individual
Prefix:DR
First Name:DINA
Middle Name:
Last Name:AL-BASSYIOUNI
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 1:8309 165TH AVE NE STE 101
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-3939
Mailing Address - Country:US
Mailing Address - Phone:425-307-1317
Mailing Address - Fax:
Practice Address - Street 1:8309 165TH AVE NE STE 101
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-3939
Practice Address - Country:US
Practice Address - Phone:425-307-1317
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-10
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA611795451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice