Provider Demographics
NPI:1952502684
Name:BAINS, RATTANJIT K (DMD)
Entity Type:Individual
Prefix:DR
First Name:RATTANJIT
Middle Name:K
Last Name:BAINS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9215 SE 40TH ST
Mailing Address - Street 2:
Mailing Address - City:MERCER ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98040-3722
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:23805 HIGHWAY 99
Practice Address - Street 2:SUITE 100
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-9204
Practice Address - Country:US
Practice Address - Phone:425-778-6333
Practice Address - Fax:425-778-6115
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000099601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice