Provider Demographics
NPI:1013980564
Name:BURNETT, DEAN ALLEN (DDS, MS, PS)
Entity Type:Individual
Prefix:DR
First Name:DEAN
Middle Name:ALLEN
Last Name:BURNETT
Suffix:
Gender:M
Credentials:DDS, MS, PS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 112TH AVE NE STE C245
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-3747
Mailing Address - Country:US
Mailing Address - Phone:425-641-3300
Mailing Address - Fax:425-641-6781
Practice Address - Street 1:1200 112TH AVE NE STE C245
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3747
Practice Address - Country:US
Practice Address - Phone:425-641-3300
Practice Address - Fax:425-641-6781
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-07
Last Update Date:2014-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA69161223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics