Provider Demographics
NPI:1487944013
Name:DAINING, LUKE DOUGLAS (DDS)
Entity type:Individual
Prefix:
First Name:LUKE
Middle Name:DOUGLAS
Last Name:DAINING
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 1:19108 33RD AVE W STE A
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-4728
Mailing Address - Country:US
Mailing Address - Phone:425-361-2856
Mailing Address - Fax:
Practice Address - Street 1:19108 33RD AVE W STE A
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-4728
Practice Address - Country:US
Practice Address - Phone:425-361-2856
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-16
Last Update Date:2016-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE603714081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice