Provider Demographics
NPI:1407020126
Name:ROBERT J. DIXEY DDS AND JAMES E. REED
Entity Type:Organization
Organization Name:ROBERT J. DIXEY DDS AND JAMES E. REED
Other - Org Name:EASTSIDE ORAL SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:O'NEIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-641-5560
Mailing Address - Street 1:1855 156TH AVE NE STE 101
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98007-4386
Mailing Address - Country:US
Mailing Address - Phone:425-641-5560
Mailing Address - Fax:425-641-5563
Practice Address - Street 1:1855 156TH AVE NE STE 101
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007-4386
Practice Address - Country:US
Practice Address - Phone:425-641-5560
Practice Address - Fax:425-641-5563
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-14
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA5611122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty