Provider Demographics
NPI:1447866959
Name:RAHUL PRAKASH, DDS, PLLC
Entity type:Organization
Organization Name:RAHUL PRAKASH, DDS, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RAHUL
Authorized Official - Middle Name:VED
Authorized Official - Last Name:PRAKASH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:425-240-3067
Mailing Address - Street 1:1801 12TH AVE STE B
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-2474
Mailing Address - Country:US
Mailing Address - Phone:425-240-3067
Mailing Address - Fax:
Practice Address - Street 1:1801 12TH AVE STE B
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-2474
Practice Address - Country:US
Practice Address - Phone:425-240-3067
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-21
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental