# KAI A MAULDING DDS PS

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

## Provider details

- **NPI number:** 1598824427
- **Authorized official:** MR. KAI ANTONY MAULDING DDS (DENTIST OWNER)
- **Authorized official phone:** (360) 357-6220

## Contact information

- **Practice address:** 1212 E 4TH AVE, OLYMPIA, WA 98506
- **Practice address phone:** (360) 357-6220
- **Practice address fax:** (360) 352-5412
- **Mailing address:** 1212 E 4TH AVE, OLYMPIA, WA 98506
- **Mailing address phone:** (360) 357-6220
- **Mailing address fax:** (360) 352-5412

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 8811 | WA | Yes |

## Other

- **Enumeration date:** 12/06/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0205264 | L & I | WA |
| 01 | — | 11181 | WASHINGTON DENTAL SERVICE | WA |
| 01 | — | 5047212 | DSHS | WA |