Evergreen Family Dental, Mill Creek, Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

EVERGREEN FAMILY DENTAL, MILL CREEK, INC

Practice address

15224 Main St Ste 301
Mill Creek, WA 98012-7332

Phone

(425) 338-4999

Fax

(425) 338-1055

NPI assigned

Dec 30, 2025

Last updated

Dec 30, 2025By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Caitlyn Bates

Title

Office Manager

Phone

(425) 338-4999

Specialties & licenses 1

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Joe Kim, DDS

  • Dentist
  • Newcastle, WA
  • NPI 1669506135
  NPD
• Donald Kim, D.D.S,

  • Dentist
  • Mill Creek, WA
  • NPI 1497953616
  NPD (past)
• Young Seop Lee, DDS

  • Dentist
  • Mill Creek, WA
  • NPI 1992974778
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1767052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767052800000",
    "number": "1396601688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15224 MAIN ST STE 301",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980127332",
            "telephone_number": "425-338-4999",
            "fax_number": "425-338-1055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15224 MAIN ST STE 301",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980127332",
            "telephone_number": "425-338-4999",
            "fax_number": "425-338-1055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN FAMILY DENTAL, MILL CREEK, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-12-30",
        "last_updated": "2025-12-30",
        "certification_date": "2025-12-30",
        "status": "A",
        "authorized_official_last_name": "BATES",
        "authorized_official_first_name": "CAITLYN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "425-338-4999"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leihua Edstrom, PHD, ABSNP
• Haley Marie Egan
• Lauren Anne Eikren, PMHNP
• Kelly Ellingson, MA
• Shannon Estrada, N.D.
• Matthew Russell Evich, MA; LMHC
• Experience Momentum, Inc - Mill Creek
• Eye Society Mill Creek PLLC
• Family Dental Care of Mill Creek
• Steven Faouaz, DMD

• General Practice Dentistry in Mill Creek, WA
• Providers in Mill Creek, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.