Surya Punjabi, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE61444835 Issued in WA

Practice address

68 SW 13TH St
Chehalis, WA 98532-3627

Phone

(360) 748-1833

NPI assigned

May 23, 2023

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Dental Professionals of Washington Quirt Mongrain Gibree PC

  • General Practice Dentistry
  • Chehalis, WA
  • NPI 1316564925
  NPD
• R.C. Downing DDS PS

  • Dentist
  • Chehalis, WA
  • NPI 1700241734
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1684800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685232000000",
    "number": "1245922723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 SW 13TH ST",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985323627",
            "telephone_number": "425-243-7922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68 SW 13TH ST",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985323627",
            "telephone_number": "360-748-1833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUNJABI",
        "first_name": "SURYA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-23",
        "last_updated": "2023-05-28",
        "certification_date": "2023-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE61444835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Avionne Makayla Pridgen, CPHT
• Krystal Rene Priest
• Hailey Prince
• Private Network Consulting
• Hope Ann Proctor, LICSW-A
• Brittany Rae Quam
• R.C. Downing DDS PS
• Radiology Associates of Lewis County Inc PC
• Kalob K Rahn, LPN
• Rainier Eye and Vision, PLLC

• General Practice Dentistry in Chehalis, WA
• Providers in Chehalis, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.