Provider Demographics
NPI:1497447676
Name:SONI, DIPTI MANISH (DENTIST)
Entity Type:Individual
Prefix:
First Name:DIPTI
Middle Name:MANISH
Last Name:SONI
Suffix:
Gender:F
Credentials:DENTIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5940 189TH PL NE
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-8569
Mailing Address - Country:US
Mailing Address - Phone:425-305-7185
Mailing Address - Fax:
Practice Address - Street 1:959 NE DISCOVERY DR
Practice Address - Street 2:
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98029-6231
Practice Address - Country:US
Practice Address - Phone:425-484-3318
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-24
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE614376661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice