Provider Demographics
NPI:1053876672
Name:HANDA, PRIYANKA (RDH, MS, BS)
Entity type:Individual
Prefix:
First Name:PRIYANKA
Middle Name:
Last Name:HANDA
Suffix:
Gender:F
Credentials:RDH, MS, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7909 229TH PL SW UNIT G
Mailing Address - Street 2:
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98026-5144
Mailing Address - Country:US
Mailing Address - Phone:206-979-1597
Mailing Address - Fax:
Practice Address - Street 1:7909 229TH PL SW UNIT G
Practice Address - Street 2:
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-5144
Practice Address - Country:US
Practice Address - Phone:206-979-1597
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-07
Last Update Date:2019-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADH60783015124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist