Provider Demographics
NPI:1639742760
Name:LOHIA, ANIYA
Entity Type:Individual
Prefix:
First Name:ANIYA
Middle Name:
Last Name:LOHIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9634 THORSK ST APT 301
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98011-3548
Mailing Address - Country:US
Mailing Address - Phone:585-967-9407
Mailing Address - Fax:
Practice Address - Street 1:5900 15TH AVE NW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107-3008
Practice Address - Country:US
Practice Address - Phone:206-801-1614
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-16
Last Update Date:2021-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE611876751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice