Provider Demographics
NPI:1467674382
Name:SCHUR, JEFFREY ALLEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:ALLEN
Last Name:SCHUR
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 1:14635 BEL-RED RD
Mailing Address - Street 2:STE E101
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98007-3932
Mailing Address - Country:US
Mailing Address - Phone:425-747-4477
Mailing Address - Fax:
Practice Address - Street 1:14635 BEL-RED RD
Practice Address - Street 2:STE E101
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007-3932
Practice Address - Country:US
Practice Address - Phone:425-747-4477
Practice Address - Fax:425-747-4321
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2021-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000063361223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA39018OtherINDUSTR INS ST FUND PROV#