Green Lake Facial Surgery PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

DE 60277222 Issued in WA

Legal business name

GREEN LAKE FACIAL SURGERY PLLC

Practice address

7900 E Green Lake Dr N
Suite 302
Seattle, WA 98103-4800

Phone

(206) 693-3906

NPI assigned

Mar 25, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Matthew Shane Epstein, DDS

Title

Owner

Phone

(120) 696-3906

Specialties & licenses 1

Addresses

Tax ID family

Green Lake Facial Surgery PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Green Lake Oral & Facial Surgery

  • Dentist
  • Shoreline, WA
  • NPI 1457008435
  NPD tax ID

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

{
    "created_epoch": "1395705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395705600000",
    "number": "1730506064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7900 E GREEN LAKE DR N",
            "address_2": "SUITE 302",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981034800",
            "telephone_number": "206-693-3906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7900 E GREEN LAKE DR N",
            "address_2": "SUITE 302",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981034800",
            "telephone_number": "206-693-3906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN LAKE FACIAL SURGERY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-25",
        "last_updated": "2014-03-25",
        "status": "A",
        "authorized_official_last_name": "EPSTEIN",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "SHANE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "120-696-3906",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "WA",
            "license": "DE 60277222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madeline Greeley
• Ronald A Greeley, MA, LMHC
• Rula Green Gladden, MD
• Green Grass Physical Therapy, LLC
• Green Lake Chiropractic & Nutritional Healing LLC
• Green Lake Family and Cosmetic Dentistry
• Green Lake Massage Health Center, LLC
• Green Point Acupuncture L.L.C.
• Robin A Green Whipple, MD
• Gianna I Green-Baskett

• Dental Clinic/Center in Seattle, WA
• Providers in Seattle, WA by specialty
• Dental Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2014; 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.