Northshore Dental Center LLC

Primary specialty

DentistTaxonomy code 122300000X

License

DE00007951 Issued in WA

Legal business name

NORTHSHORE DENTAL CENTER LLC

Doing business as

Northshore Dental Center

Practice address

18404 104TH Ave NE
Bothell, WA 98011-3414

Phone

(425) 486-2422

Fax

(425) 486-2712

NPI assigned

May 8, 2007

Last updated

Jan 12, 2023By 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

Diane Vo, DDSNPI 1417216557

Title

Owner

Phone

(425) 785-8305

Specialties & licenses 2

Addresses

Other names 1

• Northshore Dental Center Doing business as

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 2

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.

• Diane Vo

  • General Practice Dentistry
  • Bothell, WA
  • NPI 1417216557
  NPD Authorized official
• Antoinette Boi-Uyen Ngo, DDS

  • General Practice Dentistry
  • Kirkland, WA
  • NPI 1255067682
  NPD (past)

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673481600000",
    "number": "1760695282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18404 104TH AVE NE",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980113414",
            "telephone_number": "425-241-2960",
            "fax_number": "425-486-2712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18404 104TH AVE NE",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980113414",
            "telephone_number": "425-486-2422",
            "fax_number": "425-486-2712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSHORE DENTAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-08",
        "last_updated": "2023-01-12",
        "certification_date": "2023-01-12",
        "status": "A",
        "authorized_official_last_name": "VO",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-785-8305",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE00007951",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northshore Dental Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Northshore Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kevin Norris
• North Creek Retirement & Assisted Living Community LLC (North Creek Retirement & Assisted Living Community)
• North Lake Rheumatology, PLLC
• North Seattle Vision Care PLLC
• Northland Hearing Center, Inc. (A-Plus Hearing Aid Centers)
• Northshore Family Practice PLLC
• Northshore Health PLLC
• Northshore Physical Therapy
• Northshore School District
• Northshore Senior Center

• Dentist in Bothell, WA
• Providers in Bothell, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.