Provider Demographics
NPI:1558401059
Name:SAHASRABUDHE, KEERTI (BDS MSD)
Entity Type:Individual
Prefix:MRS
First Name:KEERTI
Middle Name:
Last Name:SAHASRABUDHE
Suffix:
Gender:F
Credentials:BDS MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15446 BEL RED RD
Mailing Address - Street 2:STE 100
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-5501
Mailing Address - Country:US
Mailing Address - Phone:425-558-3676
Mailing Address - Fax:425-558-3677
Practice Address - Street 1:15446 BEL RED RD
Practice Address - Street 2:STE 100
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-5501
Practice Address - Country:US
Practice Address - Phone:425-558-3676
Practice Address - Fax:425-558-3677
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2013-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE00008525122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist