Provider Demographics
NPI:1427493725
Name:REDMOND WAY DENTISTRY
Entity type:Organization
Organization Name:REDMOND WAY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:P
Authorized Official - Last Name:HOGG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:425-898-2168
Mailing Address - Street 1:15946 REDMOND WAY
Mailing Address - Street 2:SUITE 106
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-4061
Mailing Address - Country:US
Mailing Address - Phone:425-232-2168
Mailing Address - Fax:425-898-2779
Practice Address - Street 1:15946 REDMOND WAY
Practice Address - Street 2:SUITE 106
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-4061
Practice Address - Country:US
Practice Address - Phone:425-232-2168
Practice Address - Fax:425-898-2779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-01
Last Update Date:2013-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA7386261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental