Provider Demographics
NPI:1851097224
Name:ANNIKKA FROSTAD-THOMAS DDS PLLC
Entity Type:Organization
Organization Name:ANNIKKA FROSTAD-THOMAS DDS PLLC
Other - Org Name:LAKE SAMMAMISH KIDS DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNIKKA
Authorized Official - Middle Name:FROSTAD-THOMAS
Authorized Official - Last Name:FREELOVE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:425-281-1823
Mailing Address - Street 1:23955 SE 40TH PL
Mailing Address - Street 2:
Mailing Address - City:SAMMAMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98029-7569
Mailing Address - Country:US
Mailing Address - Phone:425-281-1823
Mailing Address - Fax:
Practice Address - Street 1:3014 ISSAQUAH PINE LAKE RD SE STE A
Practice Address - Street 2:
Practice Address - City:SAMMAMISH
Practice Address - State:WA
Practice Address - Zip Code:98075-7253
Practice Address - Country:US
Practice Address - Phone:425-281-1823
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-06
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental