Provider Demographics
NPI:1114324274
Name:BJ MULLIKEN DDS PLLC
Entity Type:Organization
Organization Name:BJ MULLIKEN DDS PLLC
Other - Org Name:BILL J MULLIKEN DDS PC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BILL
Authorized Official - Middle Name:
Authorized Official - Last Name:MULLIKEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:425-481-4974
Mailing Address - Street 1:16030 BOTHELL EVERETT HWY STE 280
Mailing Address - Street 2:
Mailing Address - City:MILL CREEK
Mailing Address - State:WA
Mailing Address - Zip Code:98012-1599
Mailing Address - Country:US
Mailing Address - Phone:425-481-4974
Mailing Address - Fax:425-338-4930
Practice Address - Street 1:16030 BOTHELL EVERETT HWY STE 280
Practice Address - Street 2:
Practice Address - City:MILL CREEK
Practice Address - State:WA
Practice Address - Zip Code:98012-1599
Practice Address - Country:US
Practice Address - Phone:425-481-4974
Practice Address - Fax:425-338-4930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-04
Last Update Date:2017-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA5460122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5460OtherDENTAL LICENSE #