Provider Demographics
NPI:1619418498
Name:ZACH STREIT DDS PLLC
Entity Type:Organization
Organization Name:ZACH STREIT DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:ZACH
Authorized Official - Middle Name:
Authorized Official - Last Name:STREIT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:425-771-3266
Mailing Address - Street 1:22815 EDMONDS WAY
Mailing Address - Street 2:
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98020-5041
Mailing Address - Country:US
Mailing Address - Phone:425-771-3266
Mailing Address - Fax:425-774-7917
Practice Address - Street 1:22815 EDMONDS WAY
Practice Address - Street 2:
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98020-5041
Practice Address - Country:US
Practice Address - Phone:425-771-3266
Practice Address - Fax:425-774-7917
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-14
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE60237532302F00000X, 332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No302F00000XManaged Care OrganizationsExclusive Provider Organization