MEDICARE: DR. NEDA GOHARKHAY DDS

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	1223G0001X	General Practice Dentistry	7489	WA

General Provider Information

NPI Number	:	1770504920
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NEDA GOHARKHAY DDS

Provider Business Mailing Address
First Line	:	700 NW GILMAN BLVD
Second Line	:	SUITE E 101
City	:	ISSAQUAH
State	:	WA
Zip	:	98027-5395
Country	:	US
Telephone Number	:	425-369-9100
Fax Number	:	425-369-9536

Provider Business Practice Location Address
First Line	:	700 NW GILMAN BLVD
Second Line	:	SUITE E 101
City	:	ISSAQUAH
State	:	WA
Zip	:	98027-5395
Country	:	US
Telephone Number	:	425-369-9100
Fax Number	:	425-369-9536

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

Provider Enumeration Date	:	07/22/2006
Last Update Date	:	07/08/2007

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