Provider Demographics
NPI:1932930203
Name:ANDERSON, SAVANNAH (DDS)
Entity type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2421 NW MARKET ST UNIT 312
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98107-4123
Mailing Address - Country:US
Mailing Address - Phone:785-764-6905
Mailing Address - Fax:
Practice Address - Street 1:411 STRANDER BLVD STE 105
Practice Address - Street 2:
Practice Address - City:TUKWILA
Practice Address - State:WA
Practice Address - Zip Code:98188-2961
Practice Address - Country:US
Practice Address - Phone:206-575-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-09
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE615709571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice