# JASON PEHLING DDS MS PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** TMJ Orofacial Disorders Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376598847
- **Authorized official:** DR. JASON P PEHLING DDS MS (PRESIDENT)
- **Authorized official phone:** (206) 363-8240

## Contact information

- **Practice address:** 2111 N NORTHGATE WAY, STE 221, SEATTLE, WA 98133-9018
- **Practice address phone:** (206) 363-8240
- **Practice address fax:** (206) 363-8301
- **Mailing address:** 2111 N NORTHGATE WAY, STE 221, SEATTLE, WA 98133
- **Mailing address phone:** (206) 363-8240
- **Mailing address fax:** (206) 363-8301

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | DE00008992 | WA | Yes |

## Other

- **Enumeration date:** 05/23/2006
- **Last updated:** 04/25/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 47570 | PREMERA DENTAL | WA |
| 01 | — | 93200 | REGENCE | WA |
| 01 | — | SB930 | PREMERA MEDICAL | WA |