Provider Demographics
NPI:1225888449
Name:P. V. ANGOLKAR, D.D.S., M.D.S., PLLC
Entity Type:Organization
Organization Name:P. V. ANGOLKAR, D.D.S., M.D.S., PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PADMARAJ (RAJ)
Authorized Official - Middle Name:V
Authorized Official - Last Name:ANGOLKAR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MDS
Authorized Official - Phone:206-898-9282
Mailing Address - Street 1:13530 53RD AVE S STE 100
Mailing Address - Street 2:
Mailing Address - City:TUKWILA
Mailing Address - State:WA
Mailing Address - Zip Code:98168-4784
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13530 53RD AVE S STE 100
Practice Address - Street 2:
Practice Address - City:TUKWILA
Practice Address - State:WA
Practice Address - Zip Code:98168-4784
Practice Address - Country:US
Practice Address - Phone:206-246-9656
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:P. V. ANGOLKAR, D.D.S., M.D.S., PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-03-22
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty