Healthcare Provider Details

I. General information

NPI: 1134919491
Provider Name (Legal Business Name): PRIYA VIRAL RABADIA DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2025
Last Update Date: 08/12/2025
Certification Date: 08/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7084 LAKELAND HILLS WAY SE STE 104
AUBURN WA
98092-8439
US

IV. Provider business mailing address

29689 130TH WAY SE
AUBURN WA
98092-3225
US

V. Phone/Fax

Practice location:
  • Phone: 253-329-5083
  • Fax:
Mailing address:
  • Phone: 253-332-9678
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number70018948
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: