Provider Demographics
NPI:1568537256
Name:SVINO, NINA S (DDS)
Entity Type:Individual
Prefix:
First Name:NINA
Middle Name:S
Last Name:SVINO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18515 BALLINGER WAY NE
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST PARK
Mailing Address - State:WA
Mailing Address - Zip Code:98155-2555
Mailing Address - Country:US
Mailing Address - Phone:206-306-0080
Mailing Address - Fax:206-306-0222
Practice Address - Street 1:18515 BALLINGER WAY NE
Practice Address - Street 2:
Practice Address - City:LAKE FOREST PARK
Practice Address - State:WA
Practice Address - Zip Code:98155-2555
Practice Address - Country:US
Practice Address - Phone:206-306-0080
Practice Address - Fax:206-306-0222
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000098031223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice