Provider Demographics
NPI:1396347001
Name:RANJITKAR, ABAYANTIKA (DDS)
Entity type:Individual
Prefix:
First Name:ABAYANTIKA
Middle Name:
Last Name:RANJITKAR
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 1:16630 NE 36TH CT APT GG103
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-6374
Mailing Address - Country:US
Mailing Address - Phone:425-979-6031
Mailing Address - Fax:
Practice Address - Street 1:14212 AMBAUM BLVD SW STE 1
Practice Address - Street 2:
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98166-1437
Practice Address - Country:US
Practice Address - Phone:206-343-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-09
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE61101100122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist