Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1649046210 Individual Practitioner Female Practitioner

Dr. Kathryn Gustafson , DDS

Dentist • Bothell, WA

Professional Overview & Biography Verified Profile Summary

Dr. Kathryn Gustafson, DDS is a registered healthcare professional specializing in Dentist in Bothell, WA. Practice services are available at 19515 N CREEK PKWY STE 212 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

19515 N Creek Pkwy Ste 212

Bothell, WA 980118200

Telephone 4254867764
Associated Practice Facility / Clinic
🏢 Broughton Dunn Pllc Facility NPI 1376466474

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Bothell, WA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 16.1 Yrs
Regional Practice Density
46 Specialists

Practicing in Bothell, WA (2853 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2025-07-24
Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License WA 70011443

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
Dr. Norman Bolosan , DDS

Dentist - General Practice

NPI 1811268865

Doctor of Dental Surgery

NPI 1982132478

Doctor of Dental Surgery

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

10 Historical Events
🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 24, 2025

Dentist (License #70011443 in WA)

📍
Updated Practice Location July 08, 2025

Registered at 19515 N CREEK PKWY STE 212, BOTHELL, WA 980118200 (Tel: 4254867764)

📍
Updated Business Mailing Address July 08, 2025

Registered at 17510 W MAIN ST UNIT B104, MONROE, WA 982721992 (Tel: 2063309911)

👤
Provider Name / Credentials Updated July 08, 2025

Recorded as KATHRYN GUSTAFSON, DDS

NPI Profile Active November 27, 2023

NPI status registered as active in NPPES database

📍
Updated Practice Location November 27, 2023

Registered at 1959 NE PACIFIC ST, SEATTLE, WA 981956365 (Tel: 2065430903)

📍
Updated Business Mailing Address November 27, 2023

Registered at 1959 NE PACIFIC ST, SEATTLE, WA 981956365 (Tel: 2065430903)

👤
Provider Name / Credentials Updated November 27, 2023

Recorded as KATHRYN GUSTAFSON

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 27, 2023

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration November 27, 2023

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1649046210
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 27, 2023
Last Update: July 24, 2025
Sole Proprietor: No

Mailing Address

17510 W Main St Unit B104

Monroe, WA 982721992

Phone: 2063309911

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.