Basic Information
| Provider Information | |||||||||
| NPI: | 1710298427 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WINTON | ||||||||
| FirstName: | KIMBERLY | ||||||||
| MiddleName: | ALYNA | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | DDS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 924 13TH AVE | ||||||||
| Address2: | |||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981224430 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5736455882 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1019 112TH ST SW | ||||||||
| Address2: | |||||||||
| City: | EVERETT | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982044875 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4255516001 | ||||||||
| FaxNumber: | 4255516009 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/28/2010 | ||||||||
| LastUpdateDate: | 11/21/2014 | ||||||||
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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 | 1223G0001X | DR60171708 | WA | N | Dental Providers | Dentist | General Practice | 122300000X | DE60217589 | WA | Y | Dental Providers | Dentist |
No ID Information.