Provider Demographics
NPI:1700544970
Name:SHAFEENA CHATUR DDS
Entity Type:Organization
Organization Name:SHAFEENA CHATUR DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:BRIDGFORTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-355-3395
Mailing Address - Street 1:1400 NW MARKET ST STE 102
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98107-3875
Mailing Address - Country:US
Mailing Address - Phone:206-432-9321
Mailing Address - Fax:206-428-9162
Practice Address - Street 1:1400 NW MARKET ST STE 102
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107-3875
Practice Address - Country:US
Practice Address - Phone:206-432-9321
Practice Address - Fax:206-428-9162
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-03
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty