Provider Demographics
NPI:1912194697
Name:ANNA A. DANIELI DDS PLLC
Entity Type:Organization
Organization Name:ANNA A. DANIELI DDS PLLC
Other - Org Name:ANNA A. DANIELI DDS
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:AGNIESZKA
Authorized Official - Last Name:DANIELI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:425-467-8216
Mailing Address - Street 1:1900 S PUGET DR STE 102
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98055-4404
Mailing Address - Country:US
Mailing Address - Phone:425-228-1521
Mailing Address - Fax:425-228-0380
Practice Address - Street 1:1900 S PUGET DR STE 102
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-4404
Practice Address - Country:US
Practice Address - Phone:425-228-1521
Practice Address - Fax:425-228-0380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-26
Last Update Date:2007-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00008209261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental