Provider Demographics
NPI:1760714943
Name:LIKHARI, VIKRAM (BDS, MS)
Entity Type:Individual
Prefix:DR
First Name:VIKRAM
Middle Name:
Last Name:LIKHARI
Suffix:
Gender:M
Credentials:BDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9925 NE 1ST ST
Mailing Address - Street 2:APT #28
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-5652
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14420 BEL RED RD
Practice Address - Street 2:STE 101
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007-3930
Practice Address - Country:US
Practice Address - Phone:617-512-4412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-12
Last Update Date:2010-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000109841223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics