Provider Demographics
NPI:1801340575
Name:RITUBAHLDMDPLLC
Entity type:Organization
Organization Name:RITUBAHLDMDPLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST/ MANAGER/ MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:RITU
Authorized Official - Middle Name:
Authorized Official - Last Name:BAHL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:206-524-2000
Mailing Address - Street 1:4530 UNION BAY PL NE
Mailing Address - Street 2:SUITE 207
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-4000
Mailing Address - Country:US
Mailing Address - Phone:206-524-2000
Mailing Address - Fax:206-400-2717
Practice Address - Street 1:4530 UNION BAY PL NE
Practice Address - Street 2:SUITE 207
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-4000
Practice Address - Country:US
Practice Address - Phone:206-524-2000
Practice Address - Fax:206-400-2717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-10
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE00010550261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
WADE00010550OtherWASHNGTON STATE DENTAL LICENSE
1104841923OtherNPI
WAHL60500250OtherWA DEPARTMENT OF HEALTH
WADH0460208933OtherWA DEPARTMENT OF HEALTH