Provider Demographics
NPI:1598830010
Name:VENDELAND, STUART ALLEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:ALLEN
Last Name:VENDELAND
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 S CARR RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98055-5866
Mailing Address - Country:US
Mailing Address - Phone:425-228-1033
Mailing Address - Fax:
Practice Address - Street 1:601 S CARR RD
Practice Address - Street 2:SUITE 400
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-5866
Practice Address - Country:US
Practice Address - Phone:425-228-1033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000038901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice