Provider Demographics
NPI:1942470059
Name:MERCHANT, PURVA SUHAS (BDS, MS)
Entity Type:Individual
Prefix:DR
First Name:PURVA
Middle Name:SUHAS
Last Name:MERCHANT
Suffix:
Gender:F
Credentials:BDS, MS
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Mailing Address - Street 1:2612 32ND AVE W
Mailing Address - Street 2:WA
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98199-3222
Mailing Address - Country:US
Mailing Address - Phone:425-246-4658
Mailing Address - Fax:
Practice Address - Street 1:945 ELLIOTT AVE W
Practice Address - Street 2:SUITE #101
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98119-3645
Practice Address - Country:US
Practice Address - Phone:206-743-8660
Practice Address - Fax:206-743-8766
Is Sole Proprietor?:No
Enumeration Date:2008-03-04
Last Update Date:2016-12-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WADE000108761223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5055678Medicaid