Provider Demographics
NPI:1992185052
Name:DEAN E KOIS DMD MSD PLLC
Entity Type:Organization
Organization Name:DEAN E KOIS DMD MSD PLLC
Other - Org Name:KOIS DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TARA
Authorized Official - Middle Name:LAWSON
Authorized Official - Last Name:KOIS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:206-909-4597
Mailing Address - Street 1:1001 FAIRVIEW AVE. N.
Mailing Address - Street 2:SUITE 2200
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109
Mailing Address - Country:US
Mailing Address - Phone:206-515-9500
Mailing Address - Fax:206-624-6030
Practice Address - Street 1:1119 4TH AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101
Practice Address - Country:US
Practice Address - Phone:206-623-4400
Practice Address - Fax:206-623-4411
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DEAN E KOIS DMD MSD PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-06-04
Last Update Date:2015-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA103931223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty