Provider Demographics
NPI:1558587170
Name:WINANS PLLC
Entity Type:Organization
Organization Name:WINANS PLLC
Other - Org Name:TENINO FAMILY DENTAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:KLUH
Authorized Official - Last Name:WINANS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:360-264-2353
Mailing Address - Street 1:PO BOX 734
Mailing Address - Street 2:
Mailing Address - City:TENINO
Mailing Address - State:WA
Mailing Address - Zip Code:98589-0734
Mailing Address - Country:US
Mailing Address - Phone:360-264-2353
Mailing Address - Fax:
Practice Address - Street 1:872 SUSSEX AVE E
Practice Address - Street 2:
Practice Address - City:TENINO
Practice Address - State:WA
Practice Address - Zip Code:98589-9287
Practice Address - Country:US
Practice Address - Phone:360-264-2353
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2016-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA9980122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5024740Medicaid