# MICHELLE J AMENT, DDS, PLLC

> 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
- **Other names:** Bothell Family Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1588242127
- **Authorized official:** DR. MICHELLE JACLYN AMENT DDS (OWNER, DENTIST)
- **Authorized official phone:** (248) 860-1909

## Contact information

- **Practice address:** 19214 BOTHELL WAY NE STE B, BOTHELL, WA 98011-6066
- **Practice address phone:** (248) 860-1909
- **Mailing address:** 13475 NE VILLAGE SQUARE DR UNIT D505, WOODINVILLE, WA 98072-5009
- **Mailing address phone:** (248) 860-1909

## Taxonomy

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

## Other

- **Enumeration date:** 04/01/2021
- **Last updated:** 04/01/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1316328487 | PPO | WA |