Provider Demographics
NPI:1508516386
Name:KAMPP, DILLON DAVID
Entity type:Individual
Prefix:
First Name:DILLON
Middle Name:DAVID
Last Name:KAMPP
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14321 32ND AVE NE APT C309
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-3644
Mailing Address - Country:US
Mailing Address - Phone:425-765-4645
Mailing Address - Fax:
Practice Address - Street 1:1310 J ST
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-2913
Practice Address - Country:US
Practice Address - Phone:360-676-7130
Practice Address - Fax:360-676-1125
Is Sole Proprietor?:No
Enumeration Date:2022-03-25
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA612988981223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry