Organization Active NPI

Southcenter Children'S Dentistry

  • Pediatric Dentistry
  • Tukwila, WA
National Provider Identifier
1639736119
Registry record updated May 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
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

Updated by the provider on May 8, 2025

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)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 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 Other name
  • Southcenter Kids Dentistry Other name

National Provider Directory

National Provider Directory

Locations

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.

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.

Verify at the official NPI Registry.