=====================================================
General NPI Number Information
=====================================================
NPI Number | 1922323161
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HIGHLAND DENTAL CENTER KIRKLAND
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/31/2010
-----------------------------------------------------
Last Update Date | 03/31/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9800 NE 120TH PL SUITE #D
-----------------------------------------------------
City | KIRKLAND
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98034-4220
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 425-825-0626
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9800 NE 120TH PL SUITE #D
-----------------------------------------------------
City | KIRKLAND
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98034-4220
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 425-825-0626
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. PRINCY S. REKHI
-----------------------------------------------------
Credential | DDS
-----------------------------------------------------
Telephone | 425-825-0626
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 122300000X
-----------------------------------------------------
Taxonomy Name | Dentist
-----------------------------------------------------
License Number | 9572
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------