Provider Demographics
NPI:1720493265
Name:CHMIELIAUSKAITE, MILDA (DMD, MPH)
Entity Type:Individual
Prefix:DR
First Name:MILDA
Middle Name:
Last Name:CHMIELIAUSKAITE
Suffix:
Gender:F
Credentials:DMD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1959 NE PACIFIC ST # 317C
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98195-6370
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1959 NE PACIFIC ST # B221
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195-3804
Practice Address - Country:US
Practice Address - Phone:206-685-2937
Practice Address - Fax:206-616-8577
Is Sole Proprietor?:No
Enumeration Date:2014-06-24
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE61322400122300000X, 125Q00000X, 204E00000X
OH30.024924204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
No122300000XDental ProvidersDentist
No125Q00000XDental ProvidersOral Medicinist