Provider Demographics
NPI:1316366909
Name:CASPIAN ORTHODONTICS
Entity type:Organization
Organization Name:CASPIAN ORTHODONTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HOPE
Authorized Official - Middle Name:MILDRED
Authorized Official - Last Name:AUSTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-584-3300
Mailing Address - Street 1:6003 100TH ST SW
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-2733
Mailing Address - Country:US
Mailing Address - Phone:253-584-3300
Mailing Address - Fax:253-584-4999
Practice Address - Street 1:6003 100TH ST SW
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-2733
Practice Address - Country:US
Practice Address - Phone:253-584-3300
Practice Address - Fax:253-584-4999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-10
Last Update Date:2014-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty