Provider Demographics
NPI:1427102789
Name:ADRIANOS DENTAL - HILOS DENTURE CLINIC
Entity type:Organization
Organization Name:ADRIANOS DENTAL - HILOS DENTURE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HERMINIA
Authorized Official - Middle Name:HILO
Authorized Official - Last Name:SUBARAN
Authorized Official - Suffix:
Authorized Official - Credentials:LD
Authorized Official - Phone:206-363-9223
Mailing Address - Street 1:1205 N 145TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-6202
Mailing Address - Country:US
Mailing Address - Phone:206-363-9223
Mailing Address - Fax:206-363-6550
Practice Address - Street 1:1205 N 145TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98133-6202
Practice Address - Country:US
Practice Address - Phone:206-363-9223
Practice Address - Fax:206-363-6550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered122300000XDental ProvidersDentistGroup - Multi-Specialty
Not Answered122400000XDental ProvidersDenturistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5031612Medicaid