Healthcare Provider Details

I. General information

NPI: 1962181404
Provider Name (Legal Business Name): SHAWNA SENGARA DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2023
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 WESTLAKE AVE N
SEATTLE WA
98109-5214
US

IV. Provider business mailing address

2202 8TH AVE UNIT 705
SEATTLE WA
98121-2089
US

V. Phone/Fax

Practice location:
  • Phone: 206-657-4430
  • Fax:
Mailing address:
  • Phone: 425-248-1088
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDE61442284
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: