Provider Demographics
NPI:1093460552
Name:GALOHDA, TANVI (DDS)
Entity Type:Individual
Prefix:
First Name:TANVI
Middle Name:
Last Name:GALOHDA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11404 115TH LN NE
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-4554
Mailing Address - Country:US
Mailing Address - Phone:425-362-9404
Mailing Address - Fax:
Practice Address - Street 1:11404 115TH LN NE
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-4554
Practice Address - Country:US
Practice Address - Phone:425-362-9404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-14
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE61261424122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist