Provider Demographics
NPI:1306490636
Name:PANNU, ARSHDEEP KAUR (DDS)
Entity type:Individual
Prefix:DR
First Name:ARSHDEEP
Middle Name:KAUR
Last Name:PANNU
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 1:11107 106TH AVE NE UNIT A
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-4437
Mailing Address - Country:US
Mailing Address - Phone:661-437-6792
Mailing Address - Fax:
Practice Address - Street 1:2235 148TH AVE NE
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007-3726
Practice Address - Country:US
Practice Address - Phone:661-437-6792
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-25
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA104139122300000X
WADE-61085991122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist