Provider Demographics
NPI:1699446336
Name:RENTON SMILES, LLC
Entity type:Organization
Organization Name:RENTON SMILES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:S
Authorized Official - Last Name:HONG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:425-264-5163
Mailing Address - Street 1:620 SE EVERETT MALL WAY STE 310
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-3279
Mailing Address - Country:US
Mailing Address - Phone:425-264-5163
Mailing Address - Fax:425-264-5664
Practice Address - Street 1:10700 SE 174TH ST STE 202
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-5472
Practice Address - Country:US
Practice Address - Phone:425-264-5163
Practice Address - Fax:425-264-5664
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-22
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty