Provider Demographics
NPI:1043774599
Name:PRIYANKA SHARMA,DDS,PLLC
Entity Type:Organization
Organization Name:PRIYANKA SHARMA,DDS,PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST(CEO)
Authorized Official - Prefix:DR
Authorized Official - First Name:PRIYANKA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARMA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:425-628-4942
Mailing Address - Street 1:10 143RD AVE SE
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98007-5160
Mailing Address - Country:US
Mailing Address - Phone:425-628-4942
Mailing Address - Fax:
Practice Address - Street 1:14655 NE BEL RED RD STE 104
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007-3900
Practice Address - Country:US
Practice Address - Phone:425-746-9160
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-29
Last Update Date:2019-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty