Provider Demographics
NPI:1770948473
Name:SEMIZ, TATJANA (DDS)
Entity type:Individual
Prefix:DR
First Name:TATJANA
Middle Name:
Last Name:SEMIZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 KIRKLAND WAY UNIT 301
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-6237
Mailing Address - Country:US
Mailing Address - Phone:408-688-1561
Mailing Address - Fax:
Practice Address - Street 1:2709 BICKFORD AVE STE A
Practice Address - Street 2:
Practice Address - City:SNOHOMISH
Practice Address - State:WA
Practice Address - Zip Code:98290-1766
Practice Address - Country:US
Practice Address - Phone:425-374-8451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-22
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA653301223G0001X
WA61074666122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice