Kevin Lee DDS Johann Ti DDS & Michael Hyodo DDS PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

8211 Issued in WA

Legal business name

KEVIN LEE DDS JOHANN TI DDS & MICHAEL HYODO DDS PLLC

Practice address

9612 270TH St NW
7C
Stanwood, WA 98292

Phone

(360) 629-1776

Fax

(360) 629-0541

NPI assigned

Aug 22, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Johann M Ti, DDS

Title

Partner

Phone

(360) 629-1776

Specialties & licenses 4

Addresses

Other names 1

• Stanwood Dental Care Doing business as

Locations

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1881700920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9612 270TH ST NW",
            "address_2": "7C",
            "city": "STANWOOD",
            "state": "WA",
            "postal_code": "98292",
            "telephone_number": "360-629-1776",
            "fax_number": "360-629-0541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9612 270TH ST NW",
            "address_2": "7C",
            "city": "STANWOOD",
            "state": "WA",
            "postal_code": "98292",
            "telephone_number": "360-629-1776",
            "fax_number": "360-629-0541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEVIN LEE DDS JOHANN TI DDS & MICHAEL HYODO DDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TI",
        "authorized_official_first_name": "JOHANN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "360-629-1776",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "WA",
            "license": "8211",
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "WA",
            "license": "6284",
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "WA",
            "license": "7741",
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "WA",
            "license": "9599",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stanwood Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Timothy John Kathol
• Mark Allen Keller, M.D.
• Emily Josephine Kelley-Brown, MPH, RD, CD, CSP
• Debra R Kennedy, RN, LMP
• Margaret Erskine Kepler, M.D.
• Lynda I Khisa
• Darleen Mary Kildow, LMHC, NCC
• Sora Kim
• Renee Kathleen King, MPT
• Kathleen A. Klingenberg, OTR/L

• Dental Clinic/Center in Stanwood, WA
• Providers in Stanwood, 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 Aug 22, 2020; 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.