Provider Demographics
NPI:1386852515
Name:ANDERSON, DEAN EMERY (DDS)
Entity Type:Individual
Prefix:
First Name:DEAN
Middle Name:EMERY
Last Name:ANDERSON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 LAKE WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-6591
Mailing Address - Country:US
Mailing Address - Phone:206-322-8862
Mailing Address - Fax:206-267-0866
Practice Address - Street 1:200 LAKE WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-6591
Practice Address - Country:US
Practice Address - Phone:206-322-8862
Practice Address - Fax:206-267-0866
Is Sole Proprietor?:No
Enumeration Date:2007-05-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000048221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice