Provider Demographics
NPI:1508935982
Name:SUBHERWAL, HARLEEN (DDS)
Entity Type:Individual
Prefix:
First Name:HARLEEN
Middle Name:
Last Name:SUBHERWAL
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 1:2720 152ND AVE NE UNIT 190
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-5895
Mailing Address - Country:US
Mailing Address - Phone:425-584-3242
Mailing Address - Fax:
Practice Address - Street 1:2720 152ND AVE NE UNIT 190
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-5895
Practice Address - Country:US
Practice Address - Phone:425-584-3242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA10250122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO431653349OtherTAX ID #