Healthcare Provider Details

I. General information

NPI: 1649165572
Provider Name (Legal Business Name): CHANDRASHEKHAR PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

509 OLIVE WAY STE 618
SEATTLE WA
98101-1761
US

IV. Provider business mailing address

509 OLIVE WAY STE 618
SEATTLE WA
98101-1761
US

V. Phone/Fax

Practice location:
  • Phone: 206-880-0119
  • Fax: 888-830-6339
Mailing address:
  • Phone: 206-880-0119
  • Fax: 888-830-6339

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1223X2210X
TaxonomyOrofacial Pain Dentistry
License Number
License Number State

VIII. Authorized Official

Name: HEMAMALINI CHANDRASHEKHAR
Title or Position: OWNER
Credential:
Phone: 206-880-0119