Provider Demographics
NPI:1972833713
Name:PARANJPE, AVINA KAMLAKAR (DDS, MS, PHD)
Entity Type:Individual
Prefix:
First Name:AVINA
Middle Name:KAMLAKAR
Last Name:PARANJPE
Suffix:
Gender:F
Credentials:DDS, MS, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1959 NE PACIFIC ST
Mailing Address - Street 2:BOX 357131
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98195-7131
Mailing Address - Country:US
Mailing Address - Phone:206-685-8258
Mailing Address - Fax:206-616-8545
Practice Address - Street 1:1959 NE PACIFIC ST
Practice Address - Street 2:SUITE D-453
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195-0001
Practice Address - Country:US
Practice Address - Phone:206-685-8258
Practice Address - Fax:206-616-8545
Is Sole Proprietor?:No
Enumeration Date:2009-12-29
Last Update Date:2009-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADF60123230122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist