Active NPI
Southcenter Children'S Dentistry
- Pediatric Dentistry
- Tukwila, WA
National Provider Identifier
1639736119
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- Legal business name
- SOUTHCENTER CHILDREN'S DENTISTRY
- Practice address
- 411 Strander Blvd Ste 303
Tukwila, WA 98188-2924 - Phone
- (206) 575-1130
- Fax
- (206) 575-1133
- NPI assigned
- May 21, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Matthew Yeh, DDS
- Title
- Member
- Phone
- (206) 575-1130
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | Primary |
Addresses
Primary practice location
411 Strander Blvd Ste 303
Tukwila, WA 98188-2924
Mailing address
2141 Washington St
Ferndale, WA 98248-9183
Phone (360) 676-9222
Other names 2
- Southcenter Childrens Dentistry
- Southcenter Kids Dentistry
National Provider Directory
National Provider DirectoryLocations
411 Strander Blvd
Ste 303
Tukwila, WA 98188
Phone (206) 575-1130
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pediatric Dentistry
- Issaquah, WA
- NPI 1528476108
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1558396800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1746662400000",
"number": "1639736119",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2141 WASHINGTON ST",
"city": "FERNDALE",
"state": "WA",
"postal_code": "982489183",
"telephone_number": "360-676-9222",
"fax_number": "360-676-9223"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "411 STRANDER BLVD STE 303",
"city": "TUKWILA",
"state": "WA",
"postal_code": "981882924",
"telephone_number": "206-575-1130",
"fax_number": "206-575-1133"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SOUTHCENTER CHILDREN'S DENTISTRY",
"organizational_subpart": "NO",
"enumeration_date": "2019-05-21",
"last_updated": "2025-05-08",
"certification_date": "2025-05-08",
"status": "A",
"authorized_official_last_name": "YEH",
"authorized_official_first_name": "MATTHEW",
"authorized_official_title_or_position": "MEMBER",
"authorized_official_telephone_number": "206-575-1130",
"authorized_official_credential": "DDS"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Dentist, Pediatric Dentistry",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Southcenter Childrens Dentistry",
"code": "5",
"type": "Other Name"
},
{
"organization_name": "Southcenter Kids Dentistry",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Tukwila, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 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.