IndividualActive
Mevadee Pibulniyom
NPI 1013895598 · Prosthodontics · Tacoma, WA
Provider details
- NPI number
- 1013895598
- Entity type
- Individual
- Primary specialty
- ProsthodonticsDental Providers
- Sole proprietor
- Yes
- License
- 61668744 (WA)
Specialties & taxonomies
Dental Providers
Practice location
5005 Main St Ste 107
Tacoma, WA 98407-3177
Phone: (253) 262-0024
Approximate (ZIP-level) locationGet directions
Mailing address
5005 Main St Ste 107
Tacoma, WA 98407-3177
Registry dates
- Enumerated
- 2025-08-23
- Last updated
- 2025-08-23
- Certified
- 2025-08-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.