1528256542 NPI number — DR. MARITES YAP DEL MUNDO DMD MS

Table of content: DR. MARITES YAP DEL MUNDO DMD MS (NPI 1528256542)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528256542 NPI number — DR. MARITES YAP DEL MUNDO DMD MS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DEL MUNDO
Provider First Name:
MARITES
Provider Middle Name:
YAP
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DMD MS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
YAP
Provider Other First Name:
MARITES
Provider Other Middle Name:
ESTOQUE
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
DMD, MS
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1528256542
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/09/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6950 NE CAMPUS WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HILLSBORO
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97124-5611
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
503-952-2164
Provider Business Mailing Address Fax Number:
503-526-4418

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
133 DEXTER AVE N
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98109-5103
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-324-5453
Provider Business Practice Location Address Fax Number:
206-323-2872
Provider Enumeration Date:
10/04/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223X0400X , with the licence number:  DE00010819 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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