Provider Demographics
NPI:1508337619
Name:ROSANA BISHAI DDS PLLC
Entity Type:Organization
Organization Name:ROSANA BISHAI DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROSANA
Authorized Official - Middle Name:
Authorized Official - Last Name:BISHAI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:425-985-3583
Mailing Address - Street 1:5624 117TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98006-3714
Mailing Address - Country:US
Mailing Address - Phone:425-985-3583
Mailing Address - Fax:
Practice Address - Street 1:12835 NEWCASTLE WAY
Practice Address - Street 2:SUITE 304
Practice Address - City:NEWCASTLE
Practice Address - State:WA
Practice Address - Zip Code:98056-1316
Practice Address - Country:US
Practice Address - Phone:256-441-7704
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-16
Last Update Date:2018-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty