Provider Demographics
NPI:1417398629
Name:CAREY, BRIAN MACLEOD (DDS)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:MACLEOD
Last Name:CAREY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3028 249TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:SAMMAMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98075-9421
Mailing Address - Country:US
Mailing Address - Phone:425-736-2373
Mailing Address - Fax:
Practice Address - Street 1:136 SW NORMANDY RD
Practice Address - Street 2:
Practice Address - City:NORMANDY PARK
Practice Address - State:WA
Practice Address - Zip Code:98166-3902
Practice Address - Country:US
Practice Address - Phone:206-244-3921
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-16
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE603773691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice