Provider Demographics
NPI:1487639225
Name:REKHI, PRINCY S (DDS)
Entity Type:Individual
Prefix:DR
First Name:PRINCY
Middle Name:S
Last Name:REKHI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20705 35TH DR SE
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98021-7022
Mailing Address - Country:US
Mailing Address - Phone:425-774-5511
Mailing Address - Fax:
Practice Address - Street 1:1080 KIRKLAND AVE NE
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98056-3415
Practice Address - Country:US
Practice Address - Phone:425-226-1422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE00009572122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5045281Medicaid