Provider Demographics
NPI:1700221041
Name:ZHOU, D.D.S., PH.D., PLLC
Entity Type:Organization
Organization Name:ZHOU, D.D.S., PH.D., PLLC
Other - Org Name:DES MOINES DENTAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HENG
Authorized Official - Middle Name:
Authorized Official - Last Name:ZHOU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, PHD, MS
Authorized Official - Phone:206-878-5300
Mailing Address - Street 1:22007 MARINE VIEW DR S
Mailing Address - Street 2:APT#101
Mailing Address - City:DES MOINES
Mailing Address - State:WA
Mailing Address - Zip Code:98198-6259
Mailing Address - Country:US
Mailing Address - Phone:206-878-5300
Mailing Address - Fax:206-824-4422
Practice Address - Street 1:22007 MARINE VIEW DR S
Practice Address - Street 2:APT#101
Practice Address - City:DES MOINES
Practice Address - State:WA
Practice Address - Zip Code:98198-6259
Practice Address - Country:US
Practice Address - Phone:206-878-5300
Practice Address - Fax:206-824-4422
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 Licenses
StateLicense IDTaxonomies
WADE000094681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA69389DMMedicare PIN