Provider Demographics
NPI:1184710022
Name:JANE DIEVENEY-HINKLE DDS & G STEVEN SAWICKI DDS PLLC
Entity type:Organization
Organization Name:JANE DIEVENEY-HINKLE DDS & G STEVEN SAWICKI DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:S
Authorized Official - Last Name:DIEVENEY-HINKLE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:360-734-8846
Mailing Address - Street 1:450 BIRCHWOOD AVE STE A
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-1702
Mailing Address - Country:US
Mailing Address - Phone:360-734-8846
Mailing Address - Fax:360-734-8167
Practice Address - Street 1:450 BIRCHWOOD AVE STE A
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-1702
Practice Address - Country:US
Practice Address - Phone:360-734-8846
Practice Address - Fax:360-734-8167
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA57011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5048202Medicaid