FRED EBSWORTH DDS PS
NPI 1104061969
Clinic/Center - Dental in Lake Forest Park, WA

Active since December 09, 2008
17191 BOTHELL WAY NE, SUITE 201, LAKE FOREST PARK, WA 98155(206) 362-0152(206) 365-3441 Get Directions Write a Review

NPPES record last updated: December 9, 2008. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Fred Ebsworth Dds Ps NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FRED EBSWORTH DDS PS (NPI 1104061969) is a healthcare organization registered as a dental in Lake Forest Park, Washington and active in the NPI registry since December 2008. The organization lists Charles F Ebsworth, President, as its authorized official.

NPPES Registry Identity

NPI1104061969
Entity TypeOrganization
Primary Taxonomy261QD0000X
Legal Business NameFRED EBSWORTH DDS PS
Location Address17191 BOTHELL WAY NE, SUITE 201Lake Forest Park, WA 98155-5534
Mailing Address17191 Bothell Way Ne, Suite 201Lake Forest Park, WA 98155-5534 · (206) 362-0152 · Fax (206) 365-3441
Fax(206) 365-3441
Organization SubpartNo
Authorized OfficialCharles F EbsworthPresident · (206) 362-0152
Enumeration DateDecember 9, 2008
NPI 1104061969 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities
Taxonomy Code261QD0000X
License Licensed in WA · DE00004073
17191 BOTHELL WAY NE, Lake Forest Park, WA 98155

Other Providers at the Same Location NPPES 14

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Dentist (General Practice)
17191 BOTHELL WAY NE, SUITE 201
LAKE FOREST PARK, WA 98155
Internal Medicine
17191 BOTHELL WAY NE, SUITE 205
LAKE FOREST PARK, WA 98155
Family Medicine
17191 BOTHELL WAY NE, STE 205
LAKE FOREST PARK, WA 98155
Family Medicine
17191 BOTHELL WAY NE, STE 205
LAKE FOREST PARK, WA 98155
Nurse Practitioner (Family)
17191 BOTHELL WAY NE, SUITE 205
LAKE FOREST PARK, WA 98155
Clinic/Center (Physical Therapy)
17191 BOTHELL WAY NE, SUITE B203
LAKE FOREST PARK, WA 98155
Nurse Practitioner (Family)
17191 BOTHELL WAY NE
LAKE FOREST PARK, WA 98155
Family Medicine
17191 BOTHELL WAY NE, SUITE 205
LAKE FOREST PARK, WA 98155

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Fred Ebsworth Dds Ps's NPI number?

The NPI number for Fred Ebsworth Dds Ps is 1104061969. It was assigned to this organization in the NPPES registry on December 9, 2008.

Where is Fred Ebsworth Dds Ps located?

Fred Ebsworth Dds Ps is located at 17191 Bothell Way NE Suite 201, Lake Forest Park, WA 98155. The listed phone number is (206) 362-0152.

What is Fred Ebsworth Dds Ps's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Dental, with taxonomy code 261QD0000X.

When was this NPI record last updated?

The NPPES record for Fred Ebsworth Dds Ps was last updated on December 9, 2008. NPI Profile syncs with the weekly NPPES data releases published by CMS.