=====================================================
General NPI Number Information
=====================================================
NPI Number | 1700725611
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | H.S. WALIA DDS FAGD & KUNAL WALIA DDS PS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/26/2026
-----------------------------------------------------
Last Update Date | 03/26/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 13613 MERIDIAN E STE 180
-----------------------------------------------------
City | PUYALLUP
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98373-3664
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 253-845-3000
-----------------------------------------------------
Fax | 253-845-1624
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 13613 MERIDIAN E STE 180
-----------------------------------------------------
City | PUYALLUP
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98373-3664
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 253-845-3000
-----------------------------------------------------
Fax | 253-845-1624
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. KUNAL WALIA
-----------------------------------------------------
Credential | DDS
-----------------------------------------------------
Telephone | 253-845-3000
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------