IndividualActive
Ilya Mironov, D.D.S.
NPI 1912067604 · Public Health Dentistry · Burlington, WA
Provider details
- NPI number
- 1912067604
- Entity type
- Individual
- Primary specialty
- Public Health DentistryDental Providers
- Credential
- D.D.S.
- Sex
- Male
- Sole proprietor
- No
- License
- DE 00010565 (WA)
Specialties & taxonomies
Dental Providers
Practice location
Ojh Clinic No 5 Burlington Family Dentistry
1250 S Burlington Blvd
Burlington, WA 98233
Phone: (360) 755-5600
Approximate (ZIP-level) locationGet directions
Mailing address
2385 Hughes Ave Sw
Seattle, WA 98116-1835
Registry dates
- Enumerated
- 2006-12-11
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.