Provider Demographics
NPI:1598188302
Name:SAXENA, MAYANK (DDS)
Entity Type:Individual
Prefix:
First Name:MAYANK
Middle Name:
Last Name:SAXENA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:MAX
Other - Middle Name:
Other - Last Name:SAXENA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:9 LAKE BELLEVUE DR
Mailing Address - Street 2:ST 203
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-2454
Mailing Address - Country:US
Mailing Address - Phone:425-641-4111
Mailing Address - Fax:425-641-2009
Practice Address - Street 1:9 LAKE BELLEVUE DR
Practice Address - Street 2:ST 203
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-2454
Practice Address - Country:US
Practice Address - Phone:425-641-4111
Practice Address - Fax:425-641-2009
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-29
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA607359281223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice