Provider Demographics
NPI:1013937507
Name:DIANE M. DOPPEL, D.D.S., M.S.D., P.S.
Entity Type:Organization
Organization Name:DIANE M. DOPPEL, D.D.S., M.S.D., P.S.
Other - Org Name:DR. DIANE DOPPEL, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT/ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:M
Authorized Official - Last Name:DOPPEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MSD
Authorized Official - Phone:206-682-1654
Mailing Address - Street 1:720 OLIVE WAY STE 920
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-1840
Mailing Address - Country:US
Mailing Address - Phone:206-682-1654
Mailing Address - Fax:206-682-1190
Practice Address - Street 1:720 OLIVE WAY STE 920
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-1840
Practice Address - Country:US
Practice Address - Phone:206-682-1654
Practice Address - Fax:206-682-1190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE00006461261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental