Provider Demographics
NPI:1114037108
Name:BELLEVUE SPECIALIZED DENTAL CARE
Entity Type:Organization
Organization Name:BELLEVUE SPECIALIZED DENTAL CARE
Other - Org Name:BEL-RED DENTAL CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:ARONOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MSD
Authorized Official - Phone:425-881-8448
Mailing Address - Street 1:15700 BEL RED RD
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98008-2231
Mailing Address - Country:US
Mailing Address - Phone:425-881-8448
Mailing Address - Fax:425-881-0355
Practice Address - Street 1:15700 BEL RED RD
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98008-2231
Practice Address - Country:US
Practice Address - Phone:425-881-8448
Practice Address - Fax:425-881-0355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE00008824261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental