Provider Demographics
NPI:1033095450
Name:PRIYA MISTRY DDS PC
Entity type:Organization
Organization Name:PRIYA MISTRY DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PRIYA
Authorized Official - Middle Name:PATIL
Authorized Official - Last Name:MISTRY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:503-255-8293
Mailing Address - Street 1:12518 SE 24TH ST
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98683
Mailing Address - Country:US
Mailing Address - Phone:425-256-0481
Mailing Address - Fax:
Practice Address - Street 1:16415 SE 15TH ST
Practice Address - Street 2:SUITE 103
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98683
Practice Address - Country:US
Practice Address - Phone:503-255-8293
Practice Address - Fax:503-252-1214
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-12
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty