Healthcare Provider Details

I. General information

NPI: 1295128569
Provider Name (Legal Business Name): KAVITA SAINANEE D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2015
Last Update Date: 07/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1959 NE PACIFIC ST
SEATTLE WA
98195
US

IV. Provider business mailing address

BOX 357134, 1959 NE PACIFIC STREET UNIVERSITY OF WASHINGTON DEPARTMENT OF ORAL SURGERY
SEATTLE WA
98195
US

V. Phone/Fax

Practice location:
  • Phone: 206-543-1511
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDR60555210
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: