Fred Ebsworth DDS Ps
NPI 1104061969 · Dental Clinic/Center · Lake Forest Park, WA
Fred Ebsworth DDS Ps is a Dental Clinic/Center organization in Lake Forest Park, WA (NPI 1104061969).
Provider details
- NPI number
- 1104061969
- Entity type
- Organization
- Primary specialty
- Dental Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Charles Ebsworth, President(206) 362-0152
- License
- DE00004073 (WA)
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2008-12-09
- Last updated
- 2008-12-09
Frequently asked questions
- What is Fred Ebsworth DDS Ps's NPI number?
- Fred Ebsworth DDS Ps's National Provider Identifier (NPI) is 1104061969, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Fred Ebsworth DDS Ps?
- Fred Ebsworth DDS Ps is classified in the NPPES registry as Dental Clinic/Center (Ambulatory Health Care Facilities).
- Where is Fred Ebsworth DDS Ps located?
- Fred Ebsworth DDS Ps's practice location on file with NPPES is 17191 Bothell Way Ne, Lake Forest Park, WA 98155-5534.
- What is Fred Ebsworth DDS Ps's phone number?
- The practice phone number listed in the NPPES registry for Fred Ebsworth DDS Ps is (206) 362-0152.
- Who is the authorized official for Fred Ebsworth DDS Ps?
- The authorized official listed on Fred Ebsworth DDS Ps's NPPES record is Charles Ebsworth, President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Fred Ebsworth DDS Ps's NPI active?
- Yes — Fred Ebsworth DDS Ps's NPI (1104061969) is active in the NPPES registry as of the last update on 2008-12-09.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.