Provider Demographics
NPI:1497887632
Name:NAUGHTON, DOREEN K (RDH, BSDH)
Entity Type:Individual
Prefix:
First Name:DOREEN
Middle Name:K
Last Name:NAUGHTON
Suffix:
Gender:F
Credentials:RDH, BSDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16526 21ST AVE SW
Mailing Address - Street 2:
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98166-3306
Mailing Address - Country:US
Mailing Address - Phone:206-241-2023
Mailing Address - Fax:206-241-2023
Practice Address - Street 1:16526 21ST AVE SW
Practice Address - Street 2:
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98166-3306
Practice Address - Country:US
Practice Address - Phone:206-241-2023
Practice Address - Fax:206-241-2023
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADH00002292124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5900162Medicaid