Individual
DEREK ZHAO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
14411 AMBAUM BLVD SW, BURIEN, WA 98166-1423
(206) 246-4559
Mailing address
13404 NEWCASTLE COMMONS DR APT 329, NEWCASTLE, WA 98059-3212
(206) 913-8167
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DE.61157736
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2004843
—
WA
Enumeration date
06/07/2019
Last updated
09/23/2025
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