# WASHINGTON DENTAL CORPORATION, PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Bellevue Modern Dentistry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457902595
- **Authorized official:** MICHAEL ORNELAS (OWNER)
- **Authorized official phone:** (405) 504-6218

## Contact information

- **Practice address:** 2235 148TH AVE NE, BELLEVUE, WA 98007-3726
- **Practice address phone:** (425) 458-3850
- **Practice address fax:** (425) 654-0113
- **Mailing address:** PO BOX 920050, DALLAS, TX 75392-5626
- **Mailing address phone:** (714) 845-8890

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | Yes |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 09/20/2019
- **Last updated:** 12/26/2023