Provider Demographics
NPI:1548995558
Name:PAVNEET MOMI & RAPINDER MOMI DDS, PLLC
Entity type:Organization
Organization Name:PAVNEET MOMI & RAPINDER MOMI DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAVNEET
Authorized Official - Middle Name:
Authorized Official - Last Name:MOMI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:206-335-6770
Mailing Address - Street 1:520 N OLYMPIC AVE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98223-1247
Mailing Address - Country:US
Mailing Address - Phone:360-435-4043
Mailing Address - Fax:
Practice Address - Street 1:520 N OLYMPIC AVE
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223-1247
Practice Address - Country:US
Practice Address - Phone:360-435-4043
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-22
Last Update Date:2022-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1356959357OtherOTHER
WA1760094668OtherOTHER