Provider Demographics
NPI:1144776022
Name:SYEDA BAKHTAWAR DMD PLLC
Entity Type:Organization
Organization Name:SYEDA BAKHTAWAR DMD PLLC
Other - Org Name:ARTISAN DENTAL BELLEVUE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SYEDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BAKHTAWAR
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:412-860-0696
Mailing Address - Street 1:188 106TH AVE NE
Mailing Address - Street 2:SUITE #410
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-5965
Mailing Address - Country:US
Mailing Address - Phone:425-454-2005
Mailing Address - Fax:425-454-1360
Practice Address - Street 1:188 106TH AVE NE
Practice Address - Street 2:SUITE #410
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-5965
Practice Address - Country:US
Practice Address - Phone:425-454-2005
Practice Address - Fax:425-454-1360
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-30
Last Update Date:2017-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE60238596261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental