Provider Demographics
NPI:1346543592
Name:MASSOUD KHAMI, D.D.S., JONTIANA BADEI, D.D.S., P.S.
Entity Type:Organization
Organization Name:MASSOUD KHAMI, D.D.S., JONTIANA BADEI, D.D.S., P.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JONTIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:BADEI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:425-775-6614
Mailing Address - Street 1:4410 194TH ST SW
Mailing Address - Street 2:SUITE C
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-5598
Mailing Address - Country:US
Mailing Address - Phone:425-775-6614
Mailing Address - Fax:
Practice Address - Street 1:4410 194TH ST SW
Practice Address - Street 2:SUITE C
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-5598
Practice Address - Country:US
Practice Address - Phone:425-775-6614
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-09
Last Update Date:2010-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty