Provider Demographics
NPI:1154580546
Name:LANDINO, LOUIS J (DMD)
Entity type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:J
Last Name:LANDINO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2617 CALIFORNIA AVE SW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98116-2404
Mailing Address - Country:US
Mailing Address - Phone:206-935-2414
Mailing Address - Fax:206-935-8701
Practice Address - Street 1:2617 CALIFORNIA AVE SW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98116-2404
Practice Address - Country:US
Practice Address - Phone:206-935-2414
Practice Address - Fax:206-935-8701
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-02
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA36401223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics