Provider Demographics
NPI:1710532221
Name:ESTRADA, DANIEL ANDRES (DDS)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:ANDRES
Last Name:ESTRADA
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 1:1706 N 46TH ST APT 2
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-6800
Mailing Address - Country:US
Mailing Address - Phone:509-961-4601
Mailing Address - Fax:
Practice Address - Street 1:735 N 185TH ST
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98133-3901
Practice Address - Country:US
Practice Address - Phone:206-800-3069
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-02
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE609813451223E0200X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
No1223G0001XDental ProvidersDentistGeneral Practice