=====================================================
General NPI Number Information
=====================================================
NPI Number | 1528973542
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RAKSHA NARENDRA BDS MS MSD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/14/2026
-----------------------------------------------------
Last Update Date | 08/14/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2020 116TH AVE NE STE 150
-----------------------------------------------------
City | BELLEVUE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98004-3059
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 425-300-9056
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1730 22ND AVE
-----------------------------------------------------
City | SEATTLE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98122-2981
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 631-697-9709
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 125Q00000X
-----------------------------------------------------
Taxonomy Name | Oral Medicine Dentistry
-----------------------------------------------------
License Number | DENT.DE.70153184
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------