MEDICARE: DR. TANAYA SAINATH DESHPANDE DDS

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	122300000X	Dentist	DE61393903	WA

General Provider Information

NPI Number	:	1861107021
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TANAYA SAINATH DESHPANDE DDS

Provider Business Mailing Address
First Line	:	2101 N URSULA ST UNIT 315
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80045-7422
Country	:	US
Telephone Number	:	346-719-8843
Fax Number	:

Provider Business Practice Location Address
First Line	:	5605 LAKEWOOD TOWNE CENTER BLVD SW STE B
Second Line	:
City	:	LAKEWOOD
State	:	WA
Zip	:	98499-3855
Country	:	US
Telephone Number	:	253-200-4049
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/20/2023
Last Update Date	:	01/20/2023

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