Provider Demographics
NPI:1285260067
Name:SONIA KIM TAKASAKI DMD PLLC
Entity type:Organization
Organization Name:SONIA KIM TAKASAKI DMD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SONIA
Authorized Official - Middle Name:KIM
Authorized Official - Last Name:TAKASAKI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:206-524-5700
Mailing Address - Street 1:9730 3RD AVE NE STE 204
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-2023
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:206-524-0765
Practice Address - Street 1:9730 3RD AVE NE STE 204
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-2023
Practice Address - Country:US
Practice Address - Phone:206-524-5700
Practice Address - Fax:206-524-0765
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-12
Last Update Date:2020-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental