Organization · Type 2 NPI

PSPD - Stanwood, PLLC

Pediatric Dentistry · Stanwood, WA

NPI number 1194188870 Active

Practice location

7104 265th St NW Ste 110
Stanwood, WA 98292-6250

Call (360) 339-8000 Map

Fax (360) 339-8044

Mailing address

919 State Ave Ste 104
Marysville, WA 98270-4284

Specialties and licenses

Taxonomy	Code	License
Pediatric Dentistry Primary	1223P0221X	DE00009918 (WA)

Pediatric Dentistry: An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.

NPI record

NPI: 1194188870
Entity type: Organization (Type 2)
Issued: Mar 31, 2016
Last updated: Apr 11, 2022
Status: Active
Subpart: Yes of Lugo DMD Marysville PS

Other names

<unavail>
Puget Sound Pediatric Dentistry · doing business as
Puget Sound Pediatric Dentistry · doing business as

Authorized official

Mrs. Jessica R. Knight
Accounts Receivable Manager
(360) 339-8000

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

Is this your record? How to update it.

About NPI 1194188870

PSPD - Stanwood, PLLC's National Provider Identifier is 1194188870, issued on Mar 31, 2016. The primary taxonomy on file is Pediatric Dentistry (1223P0221X), and the practice location is in Stanwood, WA. The record was last updated on Apr 11, 2022.