Provider Demographics
NPI:1710767967
Name:KAZ KITAGAITO DMD MSD MSE PLLC
Entity Type:Organization
Organization Name:KAZ KITAGAITO DMD MSD MSE PLLC
Other - Org Name:KITAGAITO ORTHODONTICS
Other - Org Type:Other Name
Authorized Official - Title/Position:ORTHODONTIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAZ
Authorized Official - Middle Name:
Authorized Official - Last Name:KITAGAITO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, MSD, MSE
Authorized Official - Phone:425-300-6395
Mailing Address - Street 1:13110 NE 85TH ST STE 106-B
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-8002
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13110 NE 85TH ST STE 106-B
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-8002
Practice Address - Country:US
Practice Address - Phone:425-300-6399
Practice Address - Fax:425-300-6398
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-04
Last Update Date:2023-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty