Provider Demographics
NPI:1841635349
Name:DICKINSON, DEVIN (DDS)
Entity type:Individual
Prefix:DR
First Name:DEVIN
Middle Name:
Last Name:DICKINSON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4008 NASSAU PL
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98201-4855
Mailing Address - Country:US
Mailing Address - Phone:206-353-2464
Mailing Address - Fax:
Practice Address - Street 1:302 E DIVISION ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223-1292
Practice Address - Country:US
Practice Address - Phone:206-353-2464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-10
Last Update Date:2013-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADENT.DE.603722631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice