Provider Demographics
NPI:1043528565
Name:ALLCARE DENTAL
Entity type:Organization
Organization Name:ALLCARE DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:MISS
Authorized Official - First Name:AMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:SALIMPOUR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:425-226-5940
Mailing Address - Street 1:17600 TALBOT RD S
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98055-5788
Mailing Address - Country:US
Mailing Address - Phone:425-226-5940
Mailing Address - Fax:
Practice Address - Street 1:17600 TALBOT RD S
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-5788
Practice Address - Country:US
Practice Address - Phone:425-226-5940
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-17
Last Update Date:2010-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA602997865305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5055140Medicaid