Provider Demographics
NPI:1508314386
Name:ARIEL J. RAIGRODSKI, DMD, PLLC
Entity Type:Organization
Organization Name:ARIEL J. RAIGRODSKI, DMD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ARIEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:RAIGRODSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, MS FACP
Authorized Official - Phone:425-771-2022
Mailing Address - Street 1:19020 33RD AVE W
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-4746
Mailing Address - Country:US
Mailing Address - Phone:425-771-2022
Mailing Address - Fax:
Practice Address - Street 1:19020 33RD AVE W
Practice Address - Street 2:SUITE 200
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-4746
Practice Address - Country:US
Practice Address - Phone:425-771-2022
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-21
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA9970261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental