Healthcare Provider Details

I. General information

NPI: 1740009406
Provider Name (Legal Business Name): BAHL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2024
Last Update Date: 01/21/2025
Certification Date: 01/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4530 UNION BAY PL NE STE 207
SEATTLE WA
98105-4000
US

IV. Provider business mailing address

6115 93RD AVE SE
MERCER ISLAND WA
98040-5045
US

V. Phone/Fax

Practice location:
  • Phone: 206-524-2000
  • Fax:
Mailing address:
  • Phone: 206-697-7821
  • Fax: 206-697-7821

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: DR. RITU BAHL
Title or Position: DENTIST
Credential: DMD
Phone: 206-697-7821