Provider Demographics
NPI:1316930217
Name:PARKER, SCOTT E (DDS)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:E
Last Name:PARKER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16455 NE 85TH ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-3673
Mailing Address - Country:US
Mailing Address - Phone:425-885-1873
Mailing Address - Fax:425-556-0763
Practice Address - Street 1:16455 NE 85TH ST
Practice Address - Street 2:SUITE 100
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-3673
Practice Address - Country:US
Practice Address - Phone:425-885-1873
Practice Address - Fax:425-556-0763
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-25
Last Update Date:2007-07-08
Deactivation Date:2006-03-27
Deactivation Code:
Reactivation Date:2006-04-03
Provider Licenses
StateLicense IDTaxonomies
WADE00008334122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist