Prime Dental Group, Llc

LBN: Prime Dental Group, Llc
Prime Dental Group, Llc is an health care organization with primary practice located at 302 Washington Ave S , Kent WA 98032-5713. The organization recently has only one registered license in Dental Providers / General Practice, which is considered as the primary health care specialty. Prime Dental Group, Llc can be contacted via phone (253) 520-3866, or through Kim, Yongjae via phone (425) 457-3638.

Contact Information

Primary practice address
302 Washington Ave S Kent WA 98032-5713
Phone: (253) 520-3866
Fax: (253) 520-3844
Website:
Map and Directions
Authorized official contact:
Name: Kim, Yongjae Doctor of Dental Surgery (DDS)
Phone: (425) 457-3638

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X DE00011116 Washington
Dental Providers / General Practice 1223G0001X DE00011115 Washington

Profile Details

NPI number 1407097850
LBN Legal business name Prime Dental Group, Llc
DBA Doing business as
Authorized official Kim, Yongjae Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Mar 16th, 2009
Last updated Oct 22nd, 2009 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407097850 NPPES
Washington MEDICAID 5059373

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