Provider Demographics
NPI:1801065032
Name:MALHI, KIRANDEEP K (DMD)
Entity type:Individual
Prefix:DR
First Name:KIRANDEEP
Middle Name:K
Last Name:MALHI
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 1:19723 HIGHWAY 99
Mailing Address - Street 2:SUITE A
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-6051
Mailing Address - Country:US
Mailing Address - Phone:425-775-3456
Mailing Address - Fax:425-775-0716
Practice Address - Street 1:19723 HIGHWAY 99
Practice Address - Street 2:SUITE A
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-6051
Practice Address - Country:US
Practice Address - Phone:425-775-3456
Practice Address - Fax:425-775-0716
Is Sole Proprietor?:No
Enumeration Date:2008-02-21
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000110521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice