# EVERGREEN FAMILY DENTISTRY BELLEVUE

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

## Provider details

- **NPI number:** 1487592739
- **Authorized official:** DR. ROBERT PARK DDS (OWNER DENTIST)
- **Authorized official phone:** (425) 643-6072

## Contact information

- **Practice address:** 15615 BEL RED RD STE D, BELLEVUE, WA 98008-2300
- **Practice address phone:** (425) 643-6072
- **Mailing address:** 15615 BEL RED RD STE D, BELLEVUE, WA 98008-2300
- **Mailing address phone:** (425) 643-6072

## Taxonomy

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

## Other

- **Enumeration date:** 03/24/2026
- **Last updated:** 03/24/2026