Provider Demographics
NPI:1699418343
Name:DENTISTRY OF BELLEVUE
Entity type:Organization
Organization Name:DENTISTRY OF BELLEVUE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GURPREET
Authorized Official - Middle Name:
Authorized Official - Last Name:KHURANA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:425-643-3912
Mailing Address - Street 1:14205 SE 36TH ST STE 365
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98006-1505
Mailing Address - Country:US
Mailing Address - Phone:425-643-3912
Mailing Address - Fax:360-805-8250
Practice Address - Street 1:14205 SE 36TH ST STE 365
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98006-1505
Practice Address - Country:US
Practice Address - Phone:425-643-3912
Practice Address - Fax:360-805-8250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-19
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental