Provider Demographics
NPI:1336398395
Name:MATTHYS, TORI NICOLE (DDS, MSD)
Entity type:Individual
Prefix:DR
First Name:TORI
Middle Name:NICOLE
Last Name:MATTHYS
Suffix:
Gender:F
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13317 NE 175TH ST STE AA
Mailing Address - Street 2:
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98072-6815
Mailing Address - Country:US
Mailing Address - Phone:425-224-7614
Mailing Address - Fax:
Practice Address - Street 1:13317 NE 175TH ST STE AA
Practice Address - Street 2:
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98072-6815
Practice Address - Country:US
Practice Address - Phone:425-224-7614
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-15
Last Update Date:2014-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE601633601223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics