Provider Demographics
NPI:1841484615
Name:E. CHARMAINE BARIZO, DDS PLLC
Entity type:Organization
Organization Name:E. CHARMAINE BARIZO, DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:E. CHARMAINE
Authorized Official - Middle Name:
Authorized Official - Last Name:BARIZO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:206-363-1900
Mailing Address - Street 1:14500 GREENWOOD AVE N
Mailing Address - Street 2:SUITE B
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-6419
Mailing Address - Country:US
Mailing Address - Phone:206-363-1900
Mailing Address - Fax:
Practice Address - Street 1:14500 GREENWOOD AVE N
Practice Address - Street 2:SUITE B
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98133-6419
Practice Address - Country:US
Practice Address - Phone:206-363-1900
Practice Address - Fax:206-440-0478
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-05
Last Update Date:2007-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE 90341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty