Provider Demographics
NPI:1053671834
Name:NURANI, MITCHELL, KIM, PC
Entity Type:Organization
Organization Name:NURANI, MITCHELL, KIM, PC
Other - Org Name:BRIGHTNOW DENTAL BELLEVUE CROSSROADS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHIFA
Authorized Official - Middle Name:A
Authorized Official - Last Name:NURANI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-578-6358
Mailing Address - Street 1:15600 NE 8TH ST
Mailing Address - Street 2:#A1
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98008-3927
Mailing Address - Country:US
Mailing Address - Phone:425-372-0036
Mailing Address - Fax:
Practice Address - Street 1:15600 NE 8TH ST
Practice Address - Street 2:#A1
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98008-3927
Practice Address - Country:US
Practice Address - Phone:425-372-0036
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-25
Last Update Date:2015-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE00008078122300000X
1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty