Provider Demographics
NPI:1366067506
Name:PUNIA, JASMEET (BDS)
Entity type:Individual
Prefix:DR
First Name:JASMEET
Middle Name:
Last Name:PUNIA
Suffix:
Gender:M
Credentials:BDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1808 MINOR AVE UNIT 1706
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-1672
Mailing Address - Country:US
Mailing Address - Phone:913-296-6649
Mailing Address - Fax:
Practice Address - Street 1:5006 E LAKE SAMMAMISH PKWY SE
Practice Address - Street 2:
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98029-9220
Practice Address - Country:US
Practice Address - Phone:425-414-7419
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-13
Last Update Date:2020-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60862689122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist