Healthcare Provider Details

I. General information

NPI: 1891659066
Provider Name (Legal Business Name): MS. POOJA KRISHNA SHETTIGAR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2025
Last Update Date: 12/12/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIVERSITY OF WASHINGTON SCHOOL OF DENTISTRY 1959 NE PACIFIC ST, NE
SEATLLE WA
98195-6395
US

IV. Provider business mailing address

UNIVERSITY OF WASHINGTON SCHOOL OF DENTISTRY 1959 NE PACIFIC ST, NE
SEATLLE WA
98195-6395
US

V. Phone/Fax

Practice location:
  • Phone: 206-543-0903
  • Fax:
Mailing address:
  • Phone: 206-543-0903
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: