Provider Demographics
NPI:1467436865
Name:JOSEPH ENGH DDS PS
Entity Type:Organization
Organization Name:JOSEPH ENGH DDS PS
Other - Org Name:BELLEVUE DENTAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRES SEC
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:GAR-KONG
Authorized Official - Last Name:ENGH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:425-821-9833
Mailing Address - Street 1:13131 120TH AVE NE
Mailing Address - Street 2:STE C
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-3037
Mailing Address - Country:US
Mailing Address - Phone:425-821-9833
Mailing Address - Fax:425-821-9443
Practice Address - Street 1:13131 120TH AVE NE
Practice Address - Street 2:STE C
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-3037
Practice Address - Country:US
Practice Address - Phone:425-821-9833
Practice Address - Fax:425-821-9443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE00008935122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5036421Medicaid