Provider Demographics
NPI:1093130247
Name:HINKLE, SVETLANA (LD)
Entity Type:Individual
Prefix:
First Name:SVETLANA
Middle Name:
Last Name:HINKLE
Suffix:
Gender:F
Credentials:LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1710 100TH PL SE STE 109
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-3839
Mailing Address - Country:US
Mailing Address - Phone:425-948-6383
Mailing Address - Fax:425-948-6150
Practice Address - Street 1:1710 100TH PL SE STE 109
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-3839
Practice Address - Country:US
Practice Address - Phone:425-948-6383
Practice Address - Fax:425-948-6150
Is Sole Proprietor?:No
Enumeration Date:2014-02-25
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADN60406207122400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122400000XDental ProvidersDenturist