Provider Demographics
NPI:1891905337
Name:CHAWLA, GEETIKA (BDS, MDS)
Entity Type:Individual
Prefix:DR
First Name:GEETIKA
Middle Name:
Last Name:CHAWLA
Suffix:
Gender:F
Credentials:BDS, MDS
Other - Prefix:DR
Other - First Name:GEETIKA
Other - Middle Name:
Other - Last Name:CHAWLA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:5313 NW BARLOW ST
Mailing Address - Street 2:
Mailing Address - City:CAMAS
Mailing Address - State:WA
Mailing Address - Zip Code:98607-7627
Mailing Address - Country:US
Mailing Address - Phone:360-921-6141
Mailing Address - Fax:360-836-8298
Practice Address - Street 1:217 SE 136TH AVE STE 103
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98684-6908
Practice Address - Country:US
Practice Address - Phone:360-836-8398
Practice Address - Fax:360-836-8298
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2022-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA8900122300000X, 1223X2210X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X2210XDental ProvidersDentistOrofacial Pain
No122300000XDental ProvidersDentist