Provider Demographics
NPI:1962181404
Name:SARRETT, SHAWNA (DDS)
Entity type:Individual
Prefix:
First Name:SHAWNA
Middle Name:
Last Name:SARRETT
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 1:10050 NE 10TH ST UNIT 102
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-4170
Mailing Address - Country:US
Mailing Address - Phone:425-248-1088
Mailing Address - Fax:
Practice Address - Street 1:16150 NE 85TH ST STE 212
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-3545
Practice Address - Country:US
Practice Address - Phone:425-867-5119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-12
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE61442284122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist