MEDICARE: DR. PRINCY S REKHI D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	DE00009572	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1487639225
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PRINCY S REKHI D.D.S.

Provider Business Mailing Address
First Line	:	20705 35TH DR SE
Second Line	:
City	:	BOTHELL
State	:	WA
Zip	:	98021-7022
Country	:	US
Telephone Number	:	425-774-5511
Fax Number	:

Provider Business Practice Location Address
First Line	:	1080 KIRKLAND AVE NE
Second Line	:
City	:	RENTON
State	:	WA
Zip	:	98056-3415
Country	:	US
Telephone Number	:	425-226-1422
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/14/2005
Last Update Date	:	07/09/2007

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