Carson Calderwood, DDS
Individual provider Active NPI Dentist · Snoqualmie, WA
NPI 1720205792 · NPPES record last updated Nov 16, 2020
Key facts
- NPI
- 1720205792
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- DE10227 (WA)
- Practice address
- 8026 Douglas Ave SE Ste 200
Snoqualmie, WA 98065-6313 - Phone
- (425) 831-1790
- Fax
- (425) 449-5942
- NPI assigned
- Apr 19, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DE10227 | WA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carson Calderwood PLLC Dba Ballard Dentistry | Current |
Accepting new patients | |
| Carson B Calderwood PLLC | Current | Accepting new patients | |
| Carson B Calderwood DDS PLLC, Dba Snoqualmie Falls Dental | Current |
Accepting new patients |
Locations
5456 Leary Ave NW
Seattle, WA 98107
Phone (206) 781-9204
8026 Douglas Ave SE
Ste 200
Snoqualmie, WA 98065
Phone (425) 831-1790
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DE10227 | WA | Yes |
Addresses
Primary practice location
8026 Douglas Ave SE Ste 200
Snoqualmie, WA 98065-6313
Mailing address
8026 Douglas Ave SE
Suite 200
Snoqualmie, WA 98065-6313
Phone (425) 831-1790
Other practice location 1
5456 Leary Ave NW
Seattle, WA 98107-4068
Phone (206) 781-9204
Other providers in Snoqualmie, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 16, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.