Provider Demographics
NPI:1982897351
Name:LAMBA, SONU (DDS)
Entity Type:Individual
Prefix:DR
First Name:SONU
Middle Name:
Last Name:LAMBA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4420 106TH ST SW
Mailing Address - Street 2:
Mailing Address - City:MUKILTEO
Mailing Address - State:WA
Mailing Address - Zip Code:98275-4700
Mailing Address - Country:US
Mailing Address - Phone:425-212-1810
Mailing Address - Fax:425-212-1812
Practice Address - Street 1:4420 106TH ST SW
Practice Address - Street 2:
Practice Address - City:MUKILTEO
Practice Address - State:WA
Practice Address - Zip Code:98275-4700
Practice Address - Country:US
Practice Address - Phone:425-212-1810
Practice Address - Fax:425-212-1812
Is Sole Proprietor?:No
Enumeration Date:2007-08-20
Last Update Date:2015-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE 601977711223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2011794Medicaid