Provider Demographics
NPI:1972546646
Name:VARMA, AJEY (DDS)
Entity type:Individual
Prefix:DR
First Name:AJEY
Middle Name:
Last Name:VARMA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2302 S. UNION AVE.
Mailing Address - Street 2:#B-17
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405
Mailing Address - Country:US
Mailing Address - Phone:253-752-6915
Mailing Address - Fax:253-752-9003
Practice Address - Street 1:2302 S. UNION AVE.
Practice Address - Street 2:#B-17
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405
Practice Address - Country:US
Practice Address - Phone:253-752-6915
Practice Address - Fax:253-752-9003
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-13
Last Update Date:2012-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA02510377641223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAB38345Medicare ID - Type Unspecified