Provider Demographics
NPI:1134501844
Name:KARYN MAI, DDS, PLLC
Entity Type:Organization
Organization Name:KARYN MAI, DDS, PLLC
Other - Org Name:WINLOCK FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KARYN
Authorized Official - Middle Name:
Authorized Official - Last Name:MAI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:360-785-4755
Mailing Address - Street 1:617 CEMETERY RD
Mailing Address - Street 2:
Mailing Address - City:WINLOCK
Mailing Address - State:WA
Mailing Address - Zip Code:98596-9303
Mailing Address - Country:US
Mailing Address - Phone:360-785-4755
Mailing Address - Fax:360-785-3336
Practice Address - Street 1:617 CEMETERY RD
Practice Address - Street 2:
Practice Address - City:WINLOCK
Practice Address - State:WA
Practice Address - Zip Code:98596-9303
Practice Address - Country:US
Practice Address - Phone:360-785-4755
Practice Address - Fax:360-785-3336
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-18
Last Update Date:2015-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE605435461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty