Provider Demographics
NPI:1245800499
Name:MILLS, CLAIRE BURKE (DDS)
Entity type:Individual
Prefix:DR
First Name:CLAIRE
Middle Name:BURKE
Last Name:MILLS
Suffix:
Gender:
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 PONTIUS AVE N APT 522
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-5841
Mailing Address - Country:US
Mailing Address - Phone:404-644-2466
Mailing Address - Fax:
Practice Address - Street 1:4922 GROVE ST
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:WA
Practice Address - Zip Code:98270-4427
Practice Address - Country:US
Practice Address - Phone:360-657-3091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-30
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE611411031223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1245800499Medicaid