# BEAUTIFUL SMILES DENTAL LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194991646
- **Authorized official:** MS. TATE TODOROVIC (OFFICE MANAGER)
- **Authorized official phone:** (425) 487-1551

## Contact information

- **Practice address:** 18521 101ST AVE NE, BOTHELL, WA 98011-3803
- **Practice address phone:** (425) 487-1551
- **Practice address fax:** (425) 487-2160
- **Mailing address:** 18521 101ST AVE NE, BOTHELL, WA 98011-3803
- **Mailing address phone:** (425) 487-1551
- **Mailing address fax:** (425) 487-2160

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | DE00010705 | WA | — |
| 1223G0001X | General Practice Dentistry | DE00010721 | WA | Yes |
| 1223P0700X | Prosthodontics | DE00009891 | WA | — |
| 122400000X | Denturist | DN00000331 | WA | — |

## Other

- **Enumeration date:** 05/05/2008
- **Last updated:** 05/05/2008