Healthcare Provider Details

I. General information

NPI: 1326328659
Provider Name (Legal Business Name): POOJA SAXENA DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2011
Last Update Date: 11/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12359 LAKE CITY WAY NE
SEATTLE WA
98125-5401
US

IV. Provider business mailing address

17126 NE 83RD CT
REDMOND WA
98052-6641
US

V. Phone/Fax

Practice location:
  • Phone: 206-205-8582
  • Fax:
Mailing address:
  • Phone: 425-301-3478
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDE 60098991
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: