Provider Demographics
NPI:1346415205
Name:ALEX JARRETT DDS PLLC
Entity Type:Organization
Organization Name:ALEX JARRETT DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:B
Authorized Official - Last Name:JARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:206-362-8088
Mailing Address - Street 1:17502 12TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98155-3769
Mailing Address - Country:US
Mailing Address - Phone:206-362-8088
Mailing Address - Fax:
Practice Address - Street 1:17502 12TH AVE NE
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98155-3769
Practice Address - Country:US
Practice Address - Phone:206-362-8088
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-22
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA109981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty