Provider Demographics
NPI:1326328659
Name:SAXENA, POOJA (DDS)
Entity Type:Individual
Prefix:
First Name:POOJA
Middle Name:
Last Name:SAXENA
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 1:17126 NE 83RD CT
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-6641
Mailing Address - Country:US
Mailing Address - Phone:425-301-3478
Mailing Address - Fax:
Practice Address - Street 1:12359 LAKE CITY WAY NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-5401
Practice Address - Country:US
Practice Address - Phone:206-205-8582
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-18
Last Update Date:2012-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE 600989911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice