# MAHADEEP VIRK DMD-EDMONDS PS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Avenue Dental Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528275278
- **Authorized official:** DR. MAHADEEP S VIRK DMD (PRESIDENT)
- **Authorized official phone:** (425) 778-6333

## Contact information

- **Practice address:** 23805 HIGHWAY 99, SUITE 100, EDMONDS, WA 98026-9204
- **Practice address phone:** (425) 778-6333
- **Practice address fax:** (425) 778-6115
- **Mailing address:** 23805 HIGHWAY 99, SUITE 100, EDMONDS, WA 98026-9204
- **Mailing address phone:** (425) 778-6333
- **Mailing address fax:** (425) 778-6115

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 05/16/2007
- **Last updated:** 08/22/2020