Provider Demographics
NPI:1720715071
Name:HIGHLAND DENTAL RENTON DOWNTOWN
Entity Type:Organization
Organization Name:HIGHLAND DENTAL RENTON DOWNTOWN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PRINCY
Authorized Official - Middle Name:S
Authorized Official - Last Name:REKHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-255-1661
Mailing Address - Street 1:5900 NE ARROWHEAD DR
Mailing Address - Street 2:
Mailing Address - City:KENMORE
Mailing Address - State:WA
Mailing Address - Zip Code:98028-5806
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:130 S 3RD PL STE 2
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-2439
Practice Address - Country:US
Practice Address - Phone:425-255-1661
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:REKHI PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-08-05
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental