Provider Demographics
NPI:1871088633
Name:ACCESS ORAL HEALTH LLC
Entity type:Organization
Organization Name:ACCESS ORAL HEALTH LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:
Authorized Official - Last Name:JULIANO
Authorized Official - Suffix:
Authorized Official - Credentials:RDH
Authorized Official - Phone:509-981-9370
Mailing Address - Street 1:3207 E 65TH AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99223-7226
Mailing Address - Country:US
Mailing Address - Phone:509-981-9370
Mailing Address - Fax:
Practice Address - Street 1:200 N BERNARD ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-0206
Practice Address - Country:US
Practice Address - Phone:509-981-9370
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-25
Last Update Date:2018-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAHL00008032124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes124Q00000XDental ProvidersDental HygienistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1881112746Medicaid