Provider Demographics
NPI:1629138284
Name:TOMAR, MEENAKSHI (DDS)
Entity Type:Individual
Prefix:DR
First Name:MEENAKSHI
Middle Name:
Last Name:TOMAR
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 1:51 W DAYTON
Mailing Address - Street 2:SUITE 301
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98020
Mailing Address - Country:US
Mailing Address - Phone:425-775-5162
Mailing Address - Fax:425-491-8100
Practice Address - Street 1:51 W DAYTON ST
Practice Address - Street 2:SUITE 301
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98020-4111
Practice Address - Country:US
Practice Address - Phone:425-775-5162
Practice Address - Fax:425-491-8100
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE 00010700122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist