Provider Demographics
NPI:1053554725
Name:ESCOBAR, JULIO ORLANDO (DDS)
Entity type:Individual
Prefix:DR
First Name:JULIO
Middle Name:ORLANDO
Last Name:ESCOBAR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 4TH LN S
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-6934
Mailing Address - Country:US
Mailing Address - Phone:310-344-7258
Mailing Address - Fax:
Practice Address - Street 1:1378 N MERIDIAN RD STE 150
Practice Address - Street 2:
Practice Address - City:KUNA
Practice Address - State:ID
Practice Address - Zip Code:83634-1687
Practice Address - Country:US
Practice Address - Phone:208-615-5544
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-10
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE606079431223P0221X
IDD-5576-PD1223P0221X
CA58096122300000X
AZ7807122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist