Provider Demographics
NPI:1861107021
Name:DESHPANDE, TANAYA SAINATH (DDS)
Entity type:Individual
Prefix:DR
First Name:TANAYA SAINATH
Middle Name:
Last Name:DESHPANDE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 N URSULA ST UNIT 315
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80045-7422
Mailing Address - Country:US
Mailing Address - Phone:346-719-8843
Mailing Address - Fax:
Practice Address - Street 1:5605 LAKEWOOD TOWNE CENTER BLVD SW STE B
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-3855
Practice Address - Country:US
Practice Address - Phone:253-200-4049
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-20
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE61393903122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist