MEDICARE: KETAN JUMANI DDS PLLC

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	1223P0221X	Pediatric Dentistry

General Provider Information

NPI Number	:	1669320156
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KETAN JUMANI DDS PLLC

Provider Business Mailing Address
First Line	:	22620 SE 4TH ST STE 120
Second Line	:
City	:	SAMMAMISH
State	:	WA
Zip	:	98074-7375
Country	:	US
Telephone Number	:	510-323-6993
Fax Number	:

Provider Business Practice Location Address
First Line	:	22620 SE 4TH ST STE 120
Second Line	:
City	:	SAMMAMISH
State	:	WA
Zip	:	98074-7375
Country	:	US
Telephone Number	:	510-323-6993
Fax Number	:

Authorized Official
Title or Position	:	PEDIATRIC DENTIST/OWNER
Name	:	KETAN S JUMANI
Credential	:	DDS MSD
Telephone Number	:	510-323-6993

Provider Enumeration Date	:	03/19/2026
Last Update Date	:	03/19/2026

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