Provider Demographics
NPI:1306390109
Name:SABRINA MANDICH, DDS, LLC
Entity Type:Organization
Organization Name:SABRINA MANDICH, DDS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LINMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-246-1000
Mailing Address - Street 1:207 SW 156TH ST STE 1
Mailing Address - Street 2:
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98166-2561
Mailing Address - Country:US
Mailing Address - Phone:206-246-1000
Mailing Address - Fax:
Practice Address - Street 1:207 SW 156TH ST STE 1
Practice Address - Street 2:
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98166-2561
Practice Address - Country:US
Practice Address - Phone:206-246-1000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-09
Last Update Date:2016-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA6008305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization