Basic Information
| Provider Information | |||||||||
| NPI: | 1326297383 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BUEHLER | ||||||||
| FirstName: | JESSICA | ||||||||
| MiddleName: | SAURINO | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | D.D.S. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | SAURINO | ||||||||
| OtherFirstName: | JESSICA | ||||||||
| OtherMiddleName: | LYNN | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | D.D.S | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 15421 MAIN STREET, SUITE 101 | ||||||||
| Address2: | DR. JESSICA BUEHLER C/O GENTLE DENTAL MILL CREEK | ||||||||
| City: | MILL CREEK | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98012 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4253168095 | ||||||||
| FaxNumber: | 4253169210 | ||||||||
| Practice Location | |||||||||
| Address1: | 15421 MAIN STREET, SUITE 101 | ||||||||
| Address2: | DR. JESSICA BUEHLER C/O GENTLE DENTAL MILL CREEK | ||||||||
| City: | MILL CREEK | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98012 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4253168095 | ||||||||
| FaxNumber: | 4253169210 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/15/2008 | ||||||||
| LastUpdateDate: | 11/19/2020 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | |||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 11/19/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223G0001X | DR60024862 | WA | Y | Dental Providers | Dentist | General Practice |
No ID Information.