Provider Demographics
NPI:1184830267
Name:HILDE, JASON L (DDS)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:L
Last Name:HILDE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 E GEORGE HOPPER RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:BURLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98233-3125
Mailing Address - Country:US
Mailing Address - Phone:360-707-5353
Mailing Address - Fax:
Practice Address - Street 1:120 E GEORGE HOPPER RD
Practice Address - Street 2:SUITE 210
Practice Address - City:BURLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98233-3125
Practice Address - Country:US
Practice Address - Phone:360-707-5353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA8441122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist