Dentist Providers In Puyallup, Washington

Search Dentist NPI records in Puyallup, WA

Search or browse through the NPI records of dentist registered healthcare providers with a business address in Puyallup, WA. The listings include accepted insurance information, Medicare acceptance status, and PECOS enrollment data. The total number of NPI records is 216, of which 60 are registered as organizations and 156 as individuals. A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

72% Individuals

28% Organizations

26% Female

46% Male

72% Individual Providers (156)28% Medical Organizations (60)26% Female Providers (57)46% Male Providers (99)

Map of Providers

We have mapped the Dentist providers in Puyallup, WA to visually represent the practice location of each individual or organization. Click on any of the the pins to see the provider details at that location.

List of Providers

Table of Dentist NPI Profiles in Puyallup, WA
NPI	Name	Address	Insurance	Medicare	PECOS
1003210014	STEVEN S. BROUGHTON, D.D.S. & ANGELA L. DUNN, D.D.S., P.L.L.C. LIGHT DENTAL STUDIOS (Organization)	8012 112TH STREET CT E SUITE #320 PUYALLUP, WA 98373 (253) 848-2331	Premera Blue Cross Blue Shield of Alaska UnitedHealthcare	Non-Participating Provider	NO
1013123181	MAHADEEP VIRK, DMD-PUYALLUP AVENUE DENTAL CARE (Organization)	10317 122ND ST E SUITE D PUYALLUP, WA 98374 (253) 435-5656		Non-Participating Provider	NO
1013147297	ANGELA LEIGH DUNN (Individual)	8012 112TH STREET CT E SUITE #320 PUYALLUP, WA 98373 (253) 848-2331	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana PacificSource Health Plans Paramount Paramount Dental Premera Blue Cross Blue Shield of Alaska Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1013174168	PHILIP WERNER KAISER (Individual)	16810 MERIDIAN E SUITE J107 PUYALLUP, WA 98375 (253) 848-7777	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Premera Blue Cross Blue Shield of Alaska Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1013367150	GIBRAN HYDER (Individual)	8012 112TH STREET CT E STE 320 PUYALLUP, WA 98373 (253) 848-2331	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Premera Blue Cross Blue Shield of Alaska Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1023253424	KIM D NORDBERG DDS, PS (Organization)	11023 CANYON RD E PUYALLUP, WA 98373 (253) 535-6666		Non-Participating Provider	NO
1023348109	THERESSA MAH (Individual)	10228 156TH ST E STE 101 PUYALLUP, WA 98374 (253) 840-0540	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Dental Health Services Florida Combined Life Humana PacificSource Health Plans Paramount Paramount Dental Premera Blue Cross Blue Shield of Alaska Renaissance Dental	Non-Participating Provider	YES
1033540893	CHING JU CHUANG (Individual)	1002 N. MERIDIAN SUITE 104A PUYALLUP, WA 98371 (253) 200-0695	Premera Blue Cross Blue Shield of Alaska	Non-Participating Provider	YES
1033614276	VIOLETA ATANASOVA STOYANOVA (Individual)	12005 MERIDIAN E STE 102 PUYALLUP, WA 98373 (253) 214-9293	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Premera Blue Cross Blue Shield of Alaska UnitedHealthcare	Non-Participating Provider	YES
1033890835	NICOLETTE ANN HECITA BULAON (Individual)	16810 MERIDIAN E STE J107 PUYALLUP, WA 98375 (253) 848-7777	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Premera Blue Cross Blue Shield of Alaska UnitedHealthcare	Non-Participating Provider	YES
1043346851	KEVIN H SAKAI (Individual)	311 RIVER RD SUITE 201 PUYALLUP, WA 98371 (253) 200-2500	Anthem Blue Cross and Blue Shield Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana PacificSource Health Plans Premera Blue Cross Blue Shield of Alaska UnitedHealthcare	Non-Participating Provider	NO
1043365455	BRENT PATRICK ROMBERG (Individual)	8116 112TH STREET CT E SUITE A PUYALLUP, WA 98373 (253) 848-5033	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana PacificSource Health Plans Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	YES
1043466378	JULIO E CHINCHILLA (Individual)	16810 MERIDIAN E STE J107 PUYALLUP, WA 98375 (253) 848-7777	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Premera Blue Cross Blue Shield of Alaska Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1053067488	PAULA STEPP PLLC (Organization)	15614 MERIDIAN E STE 400 PUYALLUP, WA 98375 (618) 363-6496	Premera Blue Cross Blue Shield of Alaska UnitedHealthcare	Non-Participating Provider	NO
1053480541	MICHAEL W. BAILEY (Individual)	10211 144TH ST E PUYALLUP, WA 98374 (253) 848-7281		Non-Participating Provider	YES
1073371100	LINDSEY BENOIT (Individual)	8012 112TH STREET CT E STE 320 PUYALLUP, WA 98373 (253) 848-2331		Non-Participating Provider	NO
1083076996	D.L. VANDERSCHELDEN, DDS, PC RAINIER DENTAL PUYALLUP (Organization)	18710 MERIDIAN E STE 216 PUYALLUP, WA 98375 (253) 846-5588		Non-Participating Provider	NO
1083178560	NIKOLAAS ENRIQUE REYNA (Individual)	8012 112TH STREET CT E STE 320 PUYALLUP, WA 98373 (253) 848-2331	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Humana Paramount Paramount Dental Premera Blue Cross Blue Shield of Alaska Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1083269682	BREINN ASHLEY BERTRAND (Individual)	13613 MERIDIAN E STE 180 PUYALLUP, WA 98373 (253) 845-3000		Non-Participating Provider	NO
1083753305	GEORGE G. GHOSN D.D.S.,P.S. (Organization)	604 S MERIDIAN PUYALLUP, WA 98371 (253) 845-7911		Non-Participating Provider	NO
1093156838	CHRISTOPHER TALMAGE BLACKER (Individual)	16420 MERIDIAN E #104 PUYALLUP, WA 98375 (253) 445-6669	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Premera Blue Cross Blue Shield of Alaska Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1093853129	ROBERT R. RADZ DDS, PS. SOUTH HILL FAMILY DENTISTRY (Organization)	10217 123RD STREET CT E SUITE 100 PUYALLUP, WA 98374 (253) 848-2988		Non-Participating Provider	NO
1104306729	TRACEY PARK (Individual)	702 S HILL PARK DR STE 201 PUYALLUP, WA 98373 (855) 433-6825		Non-Participating Provider	YES
1104839604	DEWAYNE RUSH SMITH (Individual)	8604 112TH ST E PUYALLUP, WA 98373 (253) 845-0558		Non-Participating Provider	NO
1114045804	STEVEN J URBACK DDS MAGD PS PUYALLUP VALLEY DENTAL CARE (Organization)	2921 5TH AVE NE SUITE 110 PUYALLUP, WA 98372 (253) 841-3173		Non-Participating Provider	NO
1114273422	DANIEL GILBERT SCHRUTH (Individual)	1002 N MERIDIAN STE A104 PUYALLUP, WA 98371 (253) 848-1874	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1114324795	WASHINGTON DENTAL CORPORATION PC PUYALLUP SMILES DENTISTRY (Organization)	16810 MERIDIAN E STE J107 PUYALLUP, WA 98375 (253) 848-7777		Non-Participating Provider	NO
1114331980	BRANDON GUARIGLIA (Individual)	16420 MERIDIAN E SUITE 104 PUYALLUP, WA 98375 (253) 445-6669	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Premera Blue Cross Blue Shield of Alaska Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1114381720	MEI-JEN CHEN (Individual)	8012 112TH STREET CT E #320 PUYALLUP, WA 98373 (253) 848-2331	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Premera Blue Cross Blue Shield of Alaska UnitedHealthcare	Non-Participating Provider	NO
1134429848	SMILERIGHT ORTHODONTICS (Organization)	602 MERIDIAN S PUYALLUP, WA 98371 (253) 845-7583		Non-Participating Provider	NO
1134865736	DENTAL PROFESSIONALS OF WASHINGTON QUIRT MONGRAIN GIBREE PC (Organization)	13333 MERIDIAN E STE E PUYALLUP, WA 98373 (253) 770-4342	Premera Blue Cross Blue Shield of Alaska	Non-Participating Provider	NO
1144933623	COLTON J FEIDER (Individual)	8012 112TH STREET CT E STE 320 PUYALLUP, WA 98373 (253) 848-2331	Humana Premera Blue Cross Blue Shield of Alaska Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1154304152	JOSEPH M GOSSLER (Individual)	104 39TH AVE SW SUITE E PUYALLUP, WA 98373 (253) 841-1386	Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas	Non-Participating Provider	NO
1154423259	KRISTINA M MERRIMAN (Individual)	16810 MERIDIAN E STE J107 PUYALLUP, WA 98375 (253) 848-7777	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1164919981	PUYALLUP PARK DENTAL (Organization)	13909 MERIDIAN E STE A1 PUYALLUP, WA 98373 (253) 435-0333	Premera Blue Cross Blue Shield of Alaska UnitedHealthcare	Non-Participating Provider	NO
1174411375	FEIYANG ZHUTANG (Individual)	8012 112TH STREET CT E STE 320 PUYALLUP, WA 98373 (253) 848-2331		Non-Participating Provider	NO
1174791529	ELLEN POLSKY (Individual)	9317 113TH ST E SUITE A PUYALLUP, WA 98373 (253) 848-7000	Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Premera Blue Cross Blue Shield of Alaska UnitedHealthcare	Non-Participating Provider	NO
1174914162	NAZISH HAQ (Individual)	11012 CANYON RD E STE 40 PUYALLUP, WA 98373 (206) 954-8996	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Dental Health Services Humana Paramount Paramount Dental Premera Blue Cross Blue Shield of Alaska Renaissance Dental	Non-Participating Provider	NO
1194204362	DENIZ AYDINEL (Individual)	16810 MERIDIAN E STE J107 PUYALLUP, WA 98375 (425) 512-1238	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1194369181	RUBA H TAWIL (Individual)	12005 MERIDIAN E # 102 PUYALLUP, WA 98373 (917) 445-3901	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Premera Blue Cross Blue Shield of Alaska Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1205560547	PATRICK BELL (Individual)	12005 MERIDIAN E STE 102 PUYALLUP, WA 98373 (253) 214-9293	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Premera Blue Cross Blue Shield of Alaska Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1205814043	MYRON BROWN (Individual)	4112 10TH ST SE PUYALLUP, WA 98374 (253) 845-6190		Non-Participating Provider	YES
1205983277	ROBERT R RADZ (Individual)	11201 88TH AVE E SUITE 110 PUYALLUP, WA 98373 (253) 848-2988		Non-Participating Provider	NO
1215038716	WALTER FOMBIN FOTO (Individual)	4202 10TH ST SE # 101 PUYALLUP, WA 98374 (253) 272-7574	Aetna CVS Health Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. Guardian Humana Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	YES
1215084421	JEFFREY J BRUS (Individual)	16021 MERIDIAN E PUYALLUP, WA 98375 (253) 845-1600		Non-Participating Provider	YES
1215121637	KUNAL WALIA (Individual)	13507 S MERIDIAN SOUTH HILL DENTAL CENTER PUYALLUP, WA 98373 (253) 845-3000	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Premera Blue Cross Blue Shield of Alaska Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1225409824	SHIEUN JANG (Individual)	702 S HILL PARK DR STE 201 PUYALLUP, WA 98373 (855) 433-6825		Non-Participating Provider	YES
1225473028	NURANI, MITCHELL, KIM, PC BRIGHT NOW DENTAL - PUYALLUP (Organization)	10228 156TH ST E STE 101 PUYALLUP, WA 98374 (253) 840-0540		Non-Participating Provider	NO
1235140781	CHRISTOPHER R MADSEN (Individual)	8012 112TH STREET CT E SUITE 240 PUYALLUP, WA 98373 (253) 864-0555	Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana UnitedHealthcare	Non-Participating Provider	NO
1235447384	SAMMY B D PAK DDS PLLC (Organization)	409 2ND ST NE PUYALLUP, WA 98372 (253) 845-7611	UnitedHealthcare	Non-Participating Provider	NO
1235701053	JENNY FANG (Individual)	803 39TH AVE SW STE F PUYALLUP, WA 98373 (253) 445-1500	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Paramount Paramount Dental Premera Blue Cross Blue Shield of Alaska Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1235864208	ALEX SHIN (Individual)	409 2ND ST NE PUYALLUP, WA 98372 (253) 845-7611		Non-Participating Provider	NO
1245366731	DANIEL STEVEN SMITH (Individual)	3920 10TH ST SE PUYALLUP, WA 98374 (253) 845-7800		Opted out of Medicare	YES
1245476571	JEFFREY J BRUS DMD PLLC MERIDIAN DENTAL CARE (Organization)	16021 MERIDIAN E PUYALLUP, WA 98375 (253) 845-1600		Non-Participating Provider	NO
1255400412	JOHN ROBERT ALMOND (Individual)	11102 SUNRISE BLVD E SUITE 101 PUYALLUP, WA 98374 (253) 445-0744		Non-Participating Provider	NO
1255473989	RICK Y LIEU (Individual)	8604 112TH ST E PUYALLUP, WA 98373 (253) 845-0558	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana PacificSource Health Plans Paramount Paramount Dental Premera Blue Cross Blue Shield of Alaska UnitedHealthcare	Non-Participating Provider	YES
1255965109	JOSEPH JENKINS (Individual)	3850 S MERIDIAN STE 5 PUYALLUP, WA 98373 (253) 697-0320	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1285684795	DAVID L CROUCH (Individual)	8012 112TH STREET CT E PUYALLUP, WA 98373 (253) 848-9591		Non-Participating Provider	NO
1295282747	PLA & WATTS DDS MSD PLLC (Organization)	819 39TH AVE SW STE B PUYALLUP, WA 98373 (253) 770-1500	Premera Blue Cross Blue Shield of Alaska	Non-Participating Provider	NO
1295371128	WASHINGTON DENTAL CORPORATION, PC DENTISTS OF PUYALLUP (Organization)	732 SHAW RD STE B PUYALLUP, WA 98372 (253) 267-7112	Premera Blue Cross Blue Shield of Alaska	Non-Participating Provider	NO
1295405025	PRASIDA MANDAPATI (Individual)	16810 MERIDIAN AVE E STE J107 PUYALLUP, WA 98375 (253) 848-7777	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Humana Paramount Paramount Dental Premera Blue Cross Blue Shield of Alaska Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1295454692	SHIH WEI LIN (Individual)	16810 MERIDIAN E STE J107 PUYALLUP, WA 98375 (267) 255-7834	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Humana Paramount Paramount Dental Premera Blue Cross Blue Shield of Alaska	Non-Participating Provider	NO
1295857464	HIMANSHU NIGAM (Individual)	2321 S MERIDIAN PUYALLUP, WA 98373 (253) 845-7645	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Premera Blue Cross Blue Shield of Alaska UnitedHealthcare	Non-Participating Provider	NO
1306383500	ZORAWAR SINGH, DDS, MPH, PLLC WILLOW SMILES DENTISTRY (Organization)	3850 S MERIDIAN STE 5 PUYALLUP, WA 98373 (253) 864-0310	UnitedHealthcare	Non-Participating Provider	NO
1306981022	JINSAM KWON (Individual)	16515 MERIDIAN E SUITE 100B PUYALLUP, WA 98375 (253) 770-0198	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Dental Health Services Florida Combined Life Humana Paramount Paramount Dental Premera Blue Cross Blue Shield of Alaska UnitedHealthcare	Non-Participating Provider	NO
1316234735	EHLEN & FULLER DDS PLLC JACK EHLEN, DDS & JULIE FULLER, DDS (Organization)	11208 94TH AVE E SUITE B PUYALLUP, WA 98373 (253) 848-4597		Non-Participating Provider	NO
1326212283	JEFF S HOBSON (Individual)	16021 MERIDIAN E PUYALLUP, WA 98375 (253) 845-1600		Non-Participating Provider	YES
1326474693	SHANNON S FARAZI (Individual)	10217 125TH STREET CT E PUYALLUP, WA 98374 (253) 864-4760		Non-Participating Provider	NO
1326513144	PEI JUNG CHUNG (Individual)	15514 MERIDIAN E PUYALLUP, WA 98375 (253) 268-1215		Non-Participating Provider	NO
1326778853	NEHA GUPTA (Individual)	8012 112TH STREET CT E STE 320 PUYALLUP, WA 98373 (253) 848-2331	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Humana Paramount Paramount Dental Premera Blue Cross Blue Shield of Alaska Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1346355666	DAVID ALLAN JOHNS (Individual)	11216 SUNRISE BLVD E STE 3-101 PUYALLUP, WA 98374 (253) 848-3723	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana PacificSource Health Plans Paramount Paramount Dental UnitedHealthcare	Opted out of Medicare	YES
1346858511	YURIY G UDOD (Individual)	8012 112TH STREET CT E STE 320 PUYALLUP, WA 98373 (253) 848-2331	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Premera Blue Cross Blue Shield of Alaska Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1356474191	JACK EDWARD EHLEN (Individual)	11208 B 94TH AVE E PUYALLUP, WA 98373 (253) 848-4597		Non-Participating Provider	YES
1366173601	SOO KYUNG RYU (Individual)	1002 N MERIDIAN STE A104 PUYALLUP, WA 98371 (253) 200-6248	Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Renaissance Dental	Non-Participating Provider	NO
1366796906	COHEN, MANAVI & PAKRAVAN INC PEAK DENTAL (Organization)	15815 MERIDIAN E PUYALLUP, WA 98375 (310) 820-9933		Non-Participating Provider	NO
1376021451	DEBORAH YU (Individual)	702 S HILL PARK DR STE 201 PUYALLUP, WA 98373 (855) 433-6825		Non-Participating Provider	YES
1376990077	SUSEE PRIYANKA RAVURI (Individual)	1002 N MERIDIAN STE A104 PUYALLUP, WA 98371 (619) 300-9832	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1396044517	MELISA SUSANTO (Individual)	16810 MERIDIAN E SUITE J104 PUYALLUP, WA 98375 (626) 241-2669	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life PacificSource Health Plans Paramount Paramount Dental Premera Blue Cross Blue Shield of Alaska Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1396403317	HANKS & STROYAN DENTAL, PLLC (Organization)	8012 112TH STREET CT E STE 160 PUYALLUP, WA 98373 (253) 840-0789		Non-Participating Provider	NO
1407305261	MICHAEL BALDWIN (Individual)	8012 112TH STREET CT E #320 PUYALLUP, WA 98373 (253) 848-2331	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Premera Blue Cross Blue Shield of Alaska Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1407978281	KRISTINE LAZAR GRACE (Individual)	11201 88TH AVE E #110 PUYALLUP, WA 98373 (253) 445-0022		Non-Participating Provider	NO
1417024456	ROBERT RAY WIGGINS (Individual)	13921 MERIDIAN E SUITE 108 PUYALLUP, WA 98373 (253) 841-2455	Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas	Opted out of Medicare	YES
1417384348	WASHINGTON DENTAL CORPORATION, PC PUYALLUP SMILES DENTISTRY (Organization)	16810 MERIDIAN EAST SUITE J107 PUYALLUP, WA 98375 (253) 848-7777	Humana Premera Blue Cross Blue Shield of Alaska	Non-Participating Provider	NO
1417982307	DAVID GARLAND THOMAS (Individual)	16515 MERIDIAN E STE 100B PUYALLUP, WA 98375 (253) 770-0198	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas PacificSource Health Plans Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1427214204	MONIKA MAHAJAN (Individual)	4202 10TH ST SE STE 102 PUYALLUP, WA 98374 (253) 446-2751	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Humana Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	NO
1427328525	NIKOLINA ARTHUR DMD PS (Organization)	3850 S MERIDIAN STE 5 PUYALLUP, WA 98373 (253) 864-0310		Non-Participating Provider	NO
1427576602	EUNHYUNG LIM (Individual)	16021 MERIDIAN E PUYALLUP, WA 98375 (253) 845-1600	Aetna CVS Health Anthem Blue Cross and Blue Shield Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Renaissance Dental	Non-Participating Provider	NO
1437398617	SHANE SIDHU (Individual)	7804 132ND STREET CT E PUYALLUP, WA 98373 (253) 691-3447	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Paramount Paramount Dental	Non-Participating Provider	NO
1437610516	MINWOO KIM (Individual)	10217 125TH STREET CT E FL 3 PUYALLUP, WA 98374 (253) 864-4760	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1447077839	M VIRK & H SKOUNTRIANOS (Organization)	210 4TH AVE SW PUYALLUP, WA 98371 (253) 848-4537		Non-Participating Provider	NO
1447471982	ALEX SOLIS (Individual)	602 MERIDIAN SOUTH PUYALLUP, WA 98371 (253) 845-7583	Anthem Blue Cross and Blue Shield Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana UnitedHealthcare	Non-Participating Provider	NO
1447481783	JULIE S FULLER (Individual)	11208 94TH AVE E PUYALLUP, WA 98373 (253) 848-4597		Non-Participating Provider	YES
1447604574	VERONIKA SZREDER (Individual)	8012 112TH STREET CT E STE 160 PUYALLUP, WA 98373 (538) 400-7892	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Humana Paramount Paramount Dental Premera Blue Cross Blue Shield of Alaska Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1447630116	THOMAS HENRY DDS PS DBA CANYON ORTHODONTICS CANYON ORTHODONTICS (Organization)	5620 112TH ST E SUITE 255 PUYALLUP, WA 98373 (253) 256-4000		Non-Participating Provider	NO
1447985189	STEPHANIE PHUONG-DINH NGUYEN (Individual)	702 S HILL PARK DR STE 201 PUYALLUP, WA 98373 (855) 433-6825		Non-Participating Provider	NO
1457470882	ANZI DENTAL CENTER 3 (Organization)	4202 10TH ST SE #102 PUYALLUP, WA 98374 (253) 434-4401		Non-Participating Provider	NO
1457480964	JONATHAN PERRY ORMISTON (Individual)	11208 94TH AVE E PUYALLUP, WA 98373 (253) 848-3529		Non-Participating Provider	NO
1457568339	KENG-TI LEE (Individual)	13333 MERIDIAN E SUITE E PUYALLUP, WA 98373 (253) 770-4342	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana PacificSource Health Plans Paramount Paramount Dental Premera Blue Cross Blue Shield of Alaska UnitedHealthcare	Non-Participating Provider	NO
1467546895	JEFF NERIO (Individual)	315 39TH AVE SW SUITE 1 PUYALLUP, WA 98373 (253) 845-5456		Non-Participating Provider	NO
1467691378	RICK Y. LIEU, D.D.S.,PLLC (Organization)	8604 112TH ST E PUYALLUP, WA 98373 (253) 845-0558	Premera Blue Cross Blue Shield of Alaska	Non-Participating Provider	NO
1477337830	HANBIT CHI PLLC (Organization)	18710 MERIDIAN E STE 216 PUYALLUP, WA 98375 (253) 846-5588	UnitedHealthcare	Non-Participating Provider	NO
1477627891	CHIN SHANG CHEN (Individual)	702 S HILL PARK DR STE 201 PUYALLUP, WA 98373 (253) 770-1875		Non-Participating Provider	NO
1487391918	PETER SMOLKE (Individual)	8012 112TH STREET CT E STE 320 PUYALLUP, WA 98373 (253) 848-2331	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Humana Paramount Paramount Dental Premera Blue Cross Blue Shield of Alaska Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1487730669	ROBERT KANE (Individual)	10217 125TH STREET CT E FL 3 PUYALLUP, WA 98374 (253) 864-4760	Florida Combined Life Humana	Non-Participating Provider	NO
1497177042	BRIAN POLILLO (Individual)	16810 MERIDIAN E SUITE J107 PUYALLUP, WA 98375 (253) 848-7777	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Humana Paramount Paramount Dental Premera Blue Cross Blue Shield of Alaska Renaissance Dental	Non-Participating Provider	YES
1497231526	OMAR KABIR SIDDIQUI (Individual)	16810 MERIDIAN E STE J107 PUYALLUP, WA 98375 (253) 848-7777	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Humana PacificSource Health Plans Paramount Paramount Dental Premera Blue Cross Blue Shield of Alaska Renaissance Dental Solstice Benefits UnitedHealthcare	Non-Participating Provider	NO
1497239735	NATALIIA GARIBOV (Individual)	8012 112TH STREET CT E STE 320 PUYALLUP, WA 98373 (253) 848-2331	Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas BridgeSpan Health Company Dental Health Services Regence BlueCross BlueShield of Oregon	Non-Participating Provider	NO
1508311762	BROUGHTON DUNN PLLC LIGHT DENTAL STUDIOS (Organization)	8012 112TH STREET CT E STE 320 PUYALLUP, WA 98373 (253) 848-2331		Non-Participating Provider	NO
1508600032	CHENGCHENG SHA (Individual)	8012 112TH STREET CT E STE 320 PUYALLUP, WA 98373 (253) 848-2331		Non-Participating Provider	NO
1518131473	LICHUN CHU (Individual)	16021 MERIDIAN E PUYALLUP, WA 98375 (253) 845-1600		Non-Participating Provider	NO
1518301951	BRYAN MICHAEL SWANSON (Individual)	2910 S MERIDIAN STE 120 PUYALLUP, WA 98373 (253) 445-0022	Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Premera Blue Cross Blue Shield of Alaska UnitedHealthcare	Opted out of Medicare	YES
1518507037	BRUS & LIM, PPLC (Organization)	16021 MERIDIAN E PUYALLUP, WA 98375 (253) 845-1600		Non-Participating Provider	NO
1528318425	KALDESTAD & GILL, PLLC ANCHOR ENDODONTICS (Organization)	2921 5TH AVE NE #250 PUYALLUP, WA 98372 (253) 376-3266		Non-Participating Provider	NO
1538373246	M'LISSA RAJCICH (Individual)	602 S MERIDIAN PUYALLUP, WA 98371 (253) 845-7583	Anthem Blue Cross and Blue Shield Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas	Non-Participating Provider	NO
1538460571	ELLEN POLSKY DDS (Organization)	9317 113TH ST E STE A PUYALLUP, WA 98373 (253) 848-7000	UnitedHealthcare	Non-Participating Provider	NO
1538597158	JAGDEEP SINGH GILL (Individual)	2921 5TH AVE NE STE 250 PUYALLUP, WA 98372 (253) 268-0097	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1548607344	JORDAN JAMES ZINGERMAN (Individual)	2921 5TH AVE NE STE 110 PUYALLUP, WA 98372 (253) 841-3173	Anthem Blue Cross and Blue Shield Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Humana	Non-Participating Provider	NO
1548819568	WASHINGTON DENTAL CORPORATION, PC (Organization)	12005 MERIDIAN E STE 102 PUYALLUP, WA 98373 (253) 214-9293	Premera Blue Cross Blue Shield of Alaska	Non-Participating Provider	NO
1558786145	ABEDI ADVANCED FAMILY DENTISTRY PLLC (Organization)	803 39TH AVE SW STE E PUYALLUP, WA 98373 (253) 445-1500		Non-Participating Provider	NO
1568546778	KIM E. LARSON (Individual)	4104 10TH ST SE PUYALLUP, WA 98374 (253) 841-1943		Opted out of Medicare	YES
1588341317	SANG YOON CHUNG (Individual)	8012 112TH STREET CT E STE 320 PUYALLUP, WA 98373 (253) 848-2331	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Humana Paramount Paramount Dental Premera Blue Cross Blue Shield of Alaska Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1588746127	RONALD JOSEPH WRIGHT (Individual)	819 39TH AVE SW SUITE A PUYALLUP, WA 98373 (253) 848-4300		Non-Participating Provider	NO
1588820732	CINDY YEN CHOW (Individual)	4112 10TH ST SE PUYALLUP, WA 98374 (253) 845-6190	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana PacificSource Health Plans Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1598041535	HAN & NIGAM DMD PLLC BELLASMILES OF PUYALLUP (Organization)	2321 MERIDIAN ST S PUYALLUP, WA 98373 (253) 845-7645	Premera Blue Cross Blue Shield of Alaska	Non-Participating Provider	NO
1598419145	RACHAEL HASS (Individual)	8012 112TH STREET CT E STE 320 PUYALLUP, WA 98373 (253) 848-2331	Premera Blue Cross Blue Shield of Alaska	Non-Participating Provider	NO
1598874166	DOUGLAS GUY WENZEN (Individual)	624 S MERIDIAN PUYALLUP, WA 98371 (253) 845-3301		Non-Participating Provider	NO
1609907963	HELENA STACEY SKOUNTRIANOS (Individual)	9317 113TH ST E PUYALLUP, WA 98373 (253) 845-6784		Non-Participating Provider	NO
1619047511	GUILLERMO ENRIQUE CHACON (Individual)	2910 S MERIDIAN SUITE 120 PUYALLUP, WA 98373 (253) 445-0022	Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Premera Blue Cross Blue Shield of Alaska UnitedHealthcare	Opted out of Medicare	YES
1619075744	SAMMY PAK (Individual)	409 2ND ST NE PUYALLUP, WA 98372 (253) 845-7611	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Premera Blue Cross Blue Shield of Alaska Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1619396652	CLARA W BRANNAN DDS, PS SOUTH HILL CHILDREN'S DENTISTRY (Organization)	11102 SUNRISE BLVD E STE 108 PUYALLUP, WA 98374 (253) 209-7555		Non-Participating Provider	NO
1619628666	DENNIS TRAN DDS PLLC (Organization)	210 4TH AVE SW PUYALLUP, WA 98371 (253) 848-4537		Non-Participating Provider	NO
1629398300	HD MELEC LLC EMERGENCY DENTAL CARE USA (Organization)	10217 123RD STREET CT E PUYALLUP, WA 98374 (253) 770-9911		Non-Participating Provider	NO
1639458722	KARBAKHSCH PERIODONTICS & IMPLANTS - SOUTH PLLC MK PERIODONTICS & IMPLANTS (Organization)	819 39TH AVE SW STE B PUYALLUP, WA 98373 (253) 752-6336		Non-Participating Provider	NO
1649806415	DR. HECTOR M BUSH, PC (Organization)	602 S MERIDIAN PUYALLUP, WA 98371 (253) 845-7583	UnitedHealthcare	Non-Participating Provider	NO
1659945582	YIKE LI (Individual)	109 35TH AVE SE PUYALLUP, WA 98374 (253) 799-1732	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Premera Blue Cross Blue Shield of Alaska UnitedHealthcare	Non-Participating Provider	YES
1669095063	DONG UK SHIN (Individual)	8012 112TH STREET CT E STE 320 PUYALLUP, WA 98373 (253) 571-8110	Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana UnitedHealthcare	Non-Participating Provider	NO
1669957122	VERONICA LAYACAN (Individual)	8012 112TH STREET CT E STE 320 PUYALLUP, WA 98373 (253) 848-2331	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Premera Blue Cross Blue Shield of Alaska Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1679028682	ROCHELLE J RILEY DDSMS PLLC (Organization)	2903 E MAIN PUYALLUP, WA 98372 (253) 845-9507		Non-Participating Provider	NO
1679271324	DENTAL PROFESSIONALS OF WASHINGTON, QUIRT, MONGRAIN, GIBREE, PC (Organization)	15514 MERIDIAN E PUYALLUP, WA 98375 (253) 268-1215	Premera Blue Cross Blue Shield of Alaska	Non-Participating Provider	NO
1679617609	STEVEN J URBACK (Individual)	2921 5TH AVE NE SUITE 110 PUYALLUP, WA 98372 (253) 841-3173		Non-Participating Provider	NO
1679705271	RYAN JOSEPH HANKS (Individual)	8012 112TH STREET CT E 160 PUYALLUP, WA 98373 (253) 840-0789	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1679803753	KELCEY P RHODES (Individual)	111 W MAIN PUYALLUP, WA 98371 (253) 845-0520	Anthem Blue Cross and Blue Shield Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas	Opted out of Medicare	YES
1679905368	HAN DENTAL GROUP PLLC SOUTH HILL FAMILY DENTISTRY (Organization)	11201 88TH AVE E SUITE 110 PUYALLUP, WA 98373 (253) 848-2988		Non-Participating Provider	NO
1689053159	LIGHT DENTAL STUDIOS (Organization)	8012 112TH STREET CT E SUITE #320 PUYALLUP, WA 98373 (253) 848-2331		Non-Participating Provider	NO
1689307142	MOJGAN ANSARI (Individual)	732 SHAW RD STE B PUYALLUP, WA 98372 (253) 267-7112	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Premera Blue Cross Blue Shield of Alaska Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1689750390	BRENT P TRAN (Individual)	10217 125TH STREET CT E 3RD FLOOR PUYALLUP, WA 98374 (253) 864-4760	Anthem Blue Cross and Blue Shield BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Humana Premera Blue Cross Blue Shield of Alaska	Non-Participating Provider	NO
1699455022	CECILIA THANH-DUYEN TRAN (Individual)	8012 112TH STREET CT E STE 320 PUYALLUP, WA 98373 (253) 848-2331	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1699817676	PATRICK C BEUG (Individual)	2802 S MERIDIAN PUYALLUP, WA 98373 (253) 848-3553		Non-Participating Provider	NO
1700363843	JINGQIAN YUAN (Individual)	8012 112TH STREET CT E STE 320 PUYALLUP, WA 98373 (248) 918-9842	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Premera Blue Cross Blue Shield of Alaska Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1700947702	BOB G GOLLAHER (Individual)	3850 S MERIDIAN 5 PUYALLUP, WA 98373 (253) 864-0310	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Kansas Inc. Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1710110085	VARUN SHARMA (Individual)	10317 122ND ST E STE D PUYALLUP, WA 98374 (253) 435-5656	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Premera Blue Cross Blue Shield of Alaska Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1710314158	PEDER NORDBERG (Individual)	11023 CANYON RD E PUYALLUP, WA 98373 (253) 535-6666		Non-Participating Provider	NO
1720714439	HUZAIFA YASIN D.M.D., P.S. (Organization)	11012 CANYON RD E STE 40 PUYALLUP, WA 98373 (347) 671-5042	UnitedHealthcare	Non-Participating Provider	NO
1730309113	MAHADEEP SINGH VIRK (Individual)	10317 122ND ST E SUITE D PUYALLUP, WA 98374 (253) 435-5656	Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Humana	Non-Participating Provider	NO
1730389149	DANIEL JON SPENCER (Individual)	3928 10TH ST SE PUYALLUP, WA 98374 (253) 848-1558	Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas	Non-Participating Provider	NO
1730443938	MEGAN KATHERINE BURNS (Individual)	9317 113TH ST E PUYALLUP, WA 98373 (253) 848-7000	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana PacificSource Health Plans Paramount Paramount Dental Premera Blue Cross Blue Shield of Alaska Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1730540550	MICHAEL WEI-TSI CHIEN (Individual)	2321 S MERIDIAN PUYALLUP, WA 98373 (253) 845-7645	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Companion Life Insurance Company Dominion National Guardian Humana Paramount Paramount Dental Premera Blue Cross Blue Shield of Alaska UnitedHealthcare	Non-Participating Provider	NO
1730812462	YI CHEN LU (Individual)	600 39TH AVE SW PUYALLUP, WA 98373 (253) 770-2777		Non-Participating Provider	NO
1740514561	SHAO, LEE & HSU PLLC SUNRISE DENTAL OF PUYALLUP (Organization)	13333 MERIDIAN E STE E PUYALLUP, WA 98373 (253) 770-4342		Non-Participating Provider	NO
1740778695	PEDRAUM HEYDARI (Individual)	109 N MERIDIAN SUITE A PUYALLUP, WA 98371 (253) 848-5033		Non-Participating Provider	NO
1740831387	CASSIE TRUONG (Individual)	16810 MERIDIAN E STE J107 PUYALLUP, WA 98375 (253) 905-9942	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	YES
1750685251	JONATHAN DEAN WALKER (Individual)	16008 MERIDIAN E PUYALLUP, WA 98375 (253) 864-7645	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Guardian Humana Paramount Paramount Dental Premera Blue Cross Blue Shield of Alaska Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1760141709	HANKS & STROYAN DENTAL, PLLC (Organization)	8012 112TH STREET CT E STE 160 PUYALLUP, WA 98373 (253) 840-0789	Premera Blue Cross Blue Shield of Alaska	Non-Participating Provider	NO
1760482392	STUART G HERSEY (Individual)	11201 88TH AVE E SUITE 120 PUYALLUP, WA 98373 (253) 864-9889		Non-Participating Provider	NO
1760501241	HARINDER SINGH WALIA (Individual)	13507 S MERIDIAN PUYALLUP, WA 98373 (253) 845-3000	Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Humana PacificSource Health Plans	Non-Participating Provider	NO
1760507321	ROLAND G. VANTRAMP, D.M.D.,P.S. DOVE FAMILY DENTISTRY (Organization)	600 39TH AVE SW PUYALLUP, WA 98373 (253) 770-2777	Premera Blue Cross Blue Shield of Alaska UnitedHealthcare	Non-Participating Provider	NO
1770656985	STEVEN SCOTT BROUGHTON (Individual)	8012 112TH ST CT E 320 PUYALLUP, WA 98373 (253) 848-2331	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Dental Health Services Florida Combined Life Humana PacificSource Health Plans Paramount Paramount Dental Premera Blue Cross Blue Shield of Alaska Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1770664310	GREG W. SUTHERLAND (Individual)	210 4TH AVE SW PUYALLUP, WA 98371 (253) 848-4537		Non-Participating Provider	NO
1770917551	DANIEL ALLAN ROBERTS (Individual)	702 S HILL PARK DR SUITE 201 PUYALLUP, WA 98373 (855) 433-6825	Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Guardian Premera Blue Cross Blue Shield of Alaska UnitedHealthcare	Non-Participating Provider	YES
1780236661	CHRISTOPHER WU (Individual)	16810 MERIDIAN E STE J107 PUYALLUP, WA 98375 (253) 848-7777	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1780893727	KARL D BRUBAKER (Individual)	13507 MERIDIAN E PUYALLUP, WA 98373 (253) 845-3000	Humana	Non-Participating Provider	NO
1790212470	LEVI REYNOLDS (Individual)	2921 5TH AVE NE STE 110 PUYALLUP, WA 98372 (253) 592-3687		Opted out of Medicare	NO
1790395259	THOMAS MANAOIS (Individual)	8012 112TH STREET CT E STE 320 PUYALLUP, WA 98373 (253) 848-2331	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Premera Blue Cross Blue Shield of Alaska Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1790879666	ROLAND GERARD VANTRAMP (Individual)	600 39TH AVE SW PUYALLUP, WA 98373 (253) 770-2777	Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Premera Blue Cross Blue Shield of Alaska UnitedHealthcare	Non-Participating Provider	NO
1801270269	HAN NA SEO (Individual)	16810 MERIDIAN E STE J107 PUYALLUP, WA 98375 (253) 848-7777	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Premera Blue Cross Blue Shield of Alaska Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1801494711	CAROLINE BROWN CORBETT (Individual)	8012 112TH ST CT E #320 PUYALLUP, WA 98373 (253) 848-2331	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Dental Health Services Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1821159047	SOUTH HILL CHILDRENS DENTISTRY (Organization)	11102 SUNRISE BLVD E SUITE 108 PUYALLUP, WA 98374 (253) 848-1022		Non-Participating Provider	NO
1821209297	AGATA AGNIESZKA PIKULA (Individual)	1420 3RD ST SE # 104 PUYALLUP, WA 98372 (313) 942-5723	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Premera Blue Cross Blue Shield of Alaska Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1821777517	CHRISTOPHER JAMES COKE (Individual)	12005 MERIDIAN E STE 102 PUYALLUP, WA 98373 (253) 214-9293	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Premera Blue Cross Blue Shield of Alaska UnitedHealthcare	Non-Participating Provider	NO
1831139427	PAUL W BRYAN (Individual)	2903 E MAIN PUYALLUP, WA 98372 (253) 845-9507	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas PacificSource Health Plans Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	YES
1831405158	K. A. MAULDING DDS, P.S. (Organization)	604 MERIDIAN S PUYALLUP, WA 98371 (253) 845-7911		Non-Participating Provider	NO
1831629765	JEFFREY R MILLER (Individual)	111 W MAIN PUYALLUP, WA 98371 (253) 845-0520	Anthem Blue Cross and Blue Shield Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas	Non-Participating Provider	NO
1841743796	RYAN HANKS PLLC WOODLAND DENTAL CENTER (Organization)	8012 112TH STREET CT E 160 PUYALLUP, WA 98373 (253) 840-0789		Non-Participating Provider	NO
1851428023	HARTLAND DENTAL GROUP (Organization)	3920 10TH ST SE PUYALLUP, WA 98374 (253) 845-7800		Non-Participating Provider	NO
1851605448	ERIC DAVID NORDBERG (Individual)	11025 CANYON RD E STE C PUYALLUP, WA 98373 (253) 881-1896	Premera Blue Cross Blue Shield of Alaska	Non-Participating Provider	NO
1851801435	STEPHANIE YOUNG AE YANG (Individual)	8012 112TH STREET CT E STE 320 PUYALLUP, WA 98373 (253) 848-2331		Non-Participating Provider	NO
1851846307	WALKER & HENRY PS WALKER FAMILY DENTAL (Organization)	2802 S MERIDIAN PUYALLUP, WA 98373 (253) 848-3553	Premera Blue Cross Blue Shield of Alaska	Non-Participating Provider	NO
1861033342	NICOLE HSIEH (Individual)	8012 112TH STREET CT E STE 320 PUYALLUP, WA 98373 (253) 848-2331	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Premera Blue Cross Blue Shield of Alaska Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1861168304	KATJA KESPRET (Individual)	702 S HILL PARK DR STE 201 PUYALLUP, WA 98373 (855) 433-6825	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Dental Health Services Florida Combined Life Humana Paramount Paramount Dental Premera Blue Cross Blue Shield of Alaska Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1871615658	MARK J ELMORE (Individual)	803 39TH AVE SW SUITE A PUYALLUP, WA 98373 (253) 841-1529	Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas	Non-Participating Provider	NO
1871880344	BRIAN E LILJAS (Individual)	421 W PIONEER PUYALLUP, WA 98371 (253) 845-4255	Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas	Non-Participating Provider	NO
1871942169	DR. NIKOLINA NIELSEN WILLOW SMILES DENTISTRY (Organization)	3850 S MERIDIAN STE 5 PUYALLUP, WA 98373 (253) 864-0310		Non-Participating Provider	NO
1881727592	THOMAS CHARLES RHODES (Individual)	111 W MAIN PUYALLUP, WA 98371 (253) 845-0520	Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas	Non-Participating Provider	NO
1881746238	SUNG LEE (Individual)	3712 9TH ST SW SUITE 1 PUYALLUP, WA 98373 (253) 864-4840	Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana UnitedHealthcare	Non-Participating Provider	NO
1881901247	JASON NOTARIO (Individual)	702 S HILL PARK DR STE 201 PUYALLUP, WA 98373 (855) 433-6825		Non-Participating Provider	YES
1881962272	JOSEPH MADSON (Individual)	10217 123RD STREET CT E PUYALLUP, WA 98374 (503) 442-0042	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Premera Blue Cross Blue Shield of Alaska Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1891158317	KORSMO & HENRY DDD PS PUYALLUP FAMILY DENTAL (Organization)	5620 112TH ST E SUITE 250 PUYALLUP, WA 98373 (253) 770-0529		Non-Participating Provider	NO
1891158861	KIDS CHOICE DENTAL PUYALLUP, LLC KIDS CHOICE DENTAL (Organization)	9317 113TH ST E SUITE A PUYALLUP, WA 98373 (253) 848-7000	Premera Blue Cross Blue Shield of Alaska UnitedHealthcare	Non-Participating Provider	NO
1902152713	MICHELLE S. CHUNG (Individual)	16810 MERIDIAN E UNIT J104 PUYALLUP, WA 98375 (253) 848-5437	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas BridgeSpan Health Company Delta Dental Plan of Oregon Dominion National Florida Combined Life HMSA Humana Paramount Paramount Dental Regence BlueCross BlueShield of Oregon UnitedHealthcare	Non-Participating Provider	NO
1912381831	CAMERON STROYAN (Individual)	8012 112TH STREET CT E SUITE 160 PUYALLUP, WA 98373 (253) 840-0789	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Premera Blue Cross Blue Shield of Alaska Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1912882085	COLLIN STEPHENS (Individual)	8012 112TH STREET CT E 320 PUYALLUP, WA 98373 (253) 848-2331		Non-Participating Provider	NO
1922127018	ELIZABETH HALL (Individual)	2921 5TH AVE NE SUITE 110 PUYALLUP, WA 98372 (253) 841-3173		Non-Participating Provider	YES
1922196542	WILLIAM SCOTT WIGGINS (Individual)	8012 112TH ST COURT EAST SUITE 340 PUYALLUP, WA 98373 (253) 840-0789		Non-Participating Provider	NO
1932621695	HALEY VANDERPOOL (Individual)	8012 112TH STREET CT E STE 320 PUYALLUP, WA 98373 (253) 848-2331	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Premera Blue Cross Blue Shield of Alaska Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1942336433	GREGORY JAMES WETTERHUS (Individual)	3920 10TH ST SE PUYALLUP, WA 98374 (253) 845-7800		Opted out of Medicare	YES
1942652037	RONALD MATTHEW KO (Individual)	10211 144TH ST E PUYALLUP, WA 98374 (253) 848-7281	Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Humana Renaissance Dental	Non-Participating Provider	NO
1942689419	LIGHT DENTAL STUDIOS (Organization)	8012 112TH STREET CT E #320 PUYALLUP, WA 98373 (253) 848-2331		Non-Participating Provider	NO
1942820626	GUILLERMO E CHACON, DDS, PS (Organization)	2910 S MERIDIAN STE 120 PUYALLUP, WA 98373 (253) 445-0022	Premera Blue Cross Blue Shield of Alaska UnitedHealthcare	Non-Participating Provider	NO
1952022055	SKYLER PANG (Individual)	8012 112TH STREET CT E STE 320 PUYALLUP, WA 98373 (253) 848-2331	Ambetter from Arizona Complete Health Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	YES
1952895872	SUSHMA ACHARYA SUBEDI (Individual)	2321 S MERIDIAN PUYALLUP, WA 98373 (253) 845-7645	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas EMI Health Humana Paramount Paramount Dental Solstice Healthplans of Texas Inc. TRUASSURE INSURANCE COMPANY UnitedHealthcare	Non-Participating Provider	NO
1952968356	JOSEPH KANG (Individual)	8012 112TH STREET CT E STE 320 PUYALLUP, WA 98373 (253) 848-2331		Non-Participating Provider	NO
1962540518	RUSSELL CRAIG SWENSEN (Individual)	3928 10TH ST SE PUYALLUP, WA 98374 (253) 848-1558		Non-Participating Provider	NO
1982154233	KORSMO & HENRY DDS PS PUYALLUP FAMILY DENTAL (Organization)	5620 112TH ST E STE 250 PUYALLUP, WA 98373 (253) 770-0529	Premera Blue Cross Blue Shield of Alaska	Non-Participating Provider	NO
1992059737	PUYALLUP DENTAL, LLC (Organization)	16420 MERIDIAN E PUYALLUP, WA 98375 (253) 475-9120	Premera Blue Cross Blue Shield of Alaska	Non-Participating Provider	NO
1992250260	CHELSEA CROSS MOMANY (Individual)	2921 5TH AVE NE STE 110 PUYALLUP, WA 98372 (253) 200-5553		Opted out of Medicare	NO
1992936199	JAMES MILLER (Individual)	11102 SUNRISE BLVD E 108 PUYALLUP, WA 98374 (253) 848-1022		Non-Participating Provider	NO

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