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Michelle Emily Modad
Dentist Anesthesiologist in Mercer Island, Washington
NPI 1982100475

Michelle Emily Modad is a Dentist Anesthesiologist based in Seattle, WA and is specialized in Dentist Anesthesiologist. Michelle Emily Modad practices in Mercer Island, WA. The NPI Number for Michelle Emily Modad is 1982100475 and holds a License No. DE61149859 (Washington).

The current practice location address for Michelle Emily Modad is 3023 80Th Ave Se Ste 200, Mercer Island, WA and can be reached out via phone at 206-690-5417.

Location: 3023 80Th Ave Se Ste 200, Mercer Island, WA, 98144-5008
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1982100475
Provider Name
Michelle Emily Modad
Credential
Provider Entity Type
Individual
Gender
Female
Address
3023 80Th Ave Se Ste 200, Mercer Island, WA, 98144-5008
Phone Number
206-690-5417
Fax Number
Provider Enumeration Date
04/03/2018
Last Update Date
08/17/2024
institution
Provider Business Practice Location Address Details
Address
3023 80Th Ave Se Ste 200
City
Mercer Island
State
Washington
Zip
98040-6014
Phone Number
206-690-5417
Fax Number
person
Provider Business Mailing Address Details
Address
3023 80Th Ave Se Ste 200
City
Mercer Island
State
Washington
Zip
98040-6014
Phone Number
206-690-5417
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Dentist Anesthesiologist
Taxonomy
1223D0004X
License No.
DE61149859 (Washington)
Definition
A dentist who has successfully completed an accredited postdoctoral anesthesiology residency training program for dentists of two or more years duration, in accord with Commission on Dental Accreditation's Standards for Dental Anesthesiology Residency Programs, and/or meets the eligibility requirements for examination by the American Dental Board of Anesthesiology.
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