Basic Information
| Provider Information | |||||||||
| NPI: | 1528256542 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DEL MUNDO | ||||||||
| FirstName: | MARITES | ||||||||
| MiddleName: | YAP | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DMD MS | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | YAP | ||||||||
| OtherFirstName: | MARITES | ||||||||
| OtherMiddleName: | ESTOQUE | ||||||||
| OtherNamePrefix: | DR. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | DMD, MS | ||||||||
| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | 6950 NE CAMPUS WAY | ||||||||
| Address2: | |||||||||
| City: | HILLSBORO | ||||||||
| State: | OR | ||||||||
| PostalCode: | 971245611 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5039522164 | ||||||||
| FaxNumber: | 5035264418 | ||||||||
| Practice Location | |||||||||
| Address1: | 133 DEXTER AVE N | ||||||||
| Address2: | |||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981095103 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2063245453 | ||||||||
| FaxNumber: | 2063232872 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/04/2007 | ||||||||
| LastUpdateDate: | 06/09/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223X0400X | DE00010819 | WA | Y | Dental Providers | Dentist | Orthodontics and Dentofacial Orthopedics |
No ID Information.