MEDICARE: PAVNEET MOMI & RAPINDER MOMI DDS, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1356959357	OTHER	WA	OTHER
2	1760094668	OTHER	WA	OTHER

General Provider Information

NPI Number	:	1548995558
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PAVNEET MOMI & RAPINDER MOMI DDS, PLLC

Provider Business Mailing Address
First Line	:	520 N OLYMPIC AVE
Second Line	:
City	:	ARLINGTON
State	:	WA
Zip	:	98223-1247
Country	:	US
Telephone Number	:	360-435-4043
Fax Number	:

Provider Business Practice Location Address
First Line	:	520 N OLYMPIC AVE
Second Line	:
City	:	ARLINGTON
State	:	WA
Zip	:	98223-1247
Country	:	US
Telephone Number	:	360-435-4043
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	PAVNEET MOMI
Credential	:	D.D.S.
Telephone Number	:	206-335-6770

Provider Enumeration Date	:	07/22/2022
Last Update Date	:	07/22/2022

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