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General NPI Number Information
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NPI Number | 1902777048
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Entity Type | Individual
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Provider Name | MUKTAI ABHAY DESHPANDE BDS, MS
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Gender | Female
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Dates
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Enumeration Date | 09/12/2025
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Last Update Date | 09/12/2025
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Provider Practice Location Address
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Address Line | 13501 100TH AVE NE STE 110
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City | KIRKLAND
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State | WA
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Zip | 98034-5209
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Country | US
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Telephone | 425-654-1087
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Fax |
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Provider Business Mailing Address
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Address Line | 9742 NE 119TH WAY APT D314
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City | KIRKLAND
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State | WA
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Zip | 98034-8948
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Country | US
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Telephone | 424-535-6321
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DENT.DE.70030865
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License Number State | WA
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