Provider Demographics
NPI:1588009989
Name:JESSICA J EMARD DMD, PLLC
Entity Type:Organization
Organization Name:JESSICA J EMARD DMD, PLLC
Other - Org Name:WEST EDGE DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:JANIS
Authorized Official - Last Name:EMARD
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:206-624-8500
Mailing Address - Street 1:88 SPRING ST STE 100
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-1099
Mailing Address - Country:US
Mailing Address - Phone:206-624-8500
Mailing Address - Fax:206-623-4768
Practice Address - Street 1:88 SPRING ST STE 100
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-1099
Practice Address - Country:US
Practice Address - Phone:206-624-8500
Practice Address - Fax:206-623-4768
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-30
Last Update Date:2013-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty