Provider Demographics
NPI:1720507205
Name:K.SAWYER NEGRO PLLC
Entity Type:Organization
Organization Name:K.SAWYER NEGRO PLLC
Other - Org Name:BELLINGHAM PEDIATRIC DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PEDIATRIC DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:SAWYER
Authorized Official - Last Name:NEGRO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MSD
Authorized Official - Phone:206-963-8028
Mailing Address - Street 1:1301 J ST
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-2913
Mailing Address - Country:US
Mailing Address - Phone:360-676-7130
Mailing Address - Fax:360-676-1125
Practice Address - Street 1:1301 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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA605367471223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2036602Medicaid