Provider Demographics
NPI:1912321613
Name:ESI A. QUAIDOO DDS PLLC
Entity Type:Organization
Organization Name:ESI A. QUAIDOO DDS PLLC
Other - Org Name:SMILE MATTERS NW
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALBERTA
Authorized Official - Middle Name:E
Authorized Official - Last Name:QUAIDOO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:206-466-1796
Mailing Address - Street 1:509 OLIVE WAY STE 1240
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-1765
Mailing Address - Country:US
Mailing Address - Phone:206-623-0521
Mailing Address - Fax:
Practice Address - Street 1:509 OLIVE WAY STE 1240
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-1765
Practice Address - Country:US
Practice Address - Phone:206-623-0521
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-16
Last Update Date:2014-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00006386261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental