Provider Demographics
NPI:1861800419
Name:KHURANA & PATEL PLLC
Entity type:Organization
Organization Name:KHURANA & PATEL PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMAN
Authorized Official - Middle Name:K
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:206-819-2281
Mailing Address - Street 1:120 S 15TH ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98274-4500
Mailing Address - Country:US
Mailing Address - Phone:206-819-2281
Mailing Address - Fax:360-424-7922
Practice Address - Street 1:19265 US 2
Practice Address - Street 2:SUITE 200
Practice Address - City:MONROE
Practice Address - State:WA
Practice Address - Zip Code:98272-1522
Practice Address - Country:US
Practice Address - Phone:360-805-8252
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-28
Last Update Date:2014-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE00010369122300000X
WADE60222405122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty