Provider Demographics
NPI:1235944646
Name:SUGANDH PRAVIN RELAN DDS PC
Entity type:Organization
Organization Name:SUGANDH PRAVIN RELAN DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:SUGANDH
Authorized Official - Middle Name:PRAVIN
Authorized Official - Last Name:RELAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:425-394-3093
Mailing Address - Street 1:4232 146TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98006-1608
Mailing Address - Country:US
Mailing Address - Phone:425-394-3093
Mailing Address - Fax:425-614-1612
Practice Address - Street 1:410 BELLEVUE WAY SE STE 302
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-6649
Practice Address - Country:US
Practice Address - Phone:425-454-4610
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-12
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental