Avneet Kaur Dhaliwal, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

61562458 Issued in WA

Practice address

5712 E Lake Sammamish Pkwy SE Ste 108
Issaquah, WA 98029-8943

Phone

(425) 392-3900

NPI assigned

Jul 17, 2024

Last updated

Jul 17, 2024By the provider in NPPES

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dr. Dhaliwal DMD PLLC

  dba Lake Sammamish Family Dentistry

  • Dental Clinic/Center
  • Issaquah, WA
  • NPI 1992551725
  NPD
• Lake Sammamish Family Dentistry

  • General Practice Dentistry
  • Issaquah, WA
  • NPI 1093036709
  NPD (past)

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

{
    "created_epoch": "1721174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1366280125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13309 SE 261ST PL",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980423507",
            "telephone_number": "253-391-9648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5712 E LAKE SAMMAMISH PKWY SE STE 108",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980298943",
            "telephone_number": "425-392-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DHALIWAL",
        "first_name": "AVNEET",
        "middle_name": "KAUR",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-17",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "61562458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• McKenzie Desjarlais, M.S. CF-SLP
• Nattika Detskultorn
• Lechic Devereaux Franco
• Chaitra Elise Devereaux, PSYD
• Jennifer Michelle Devine, MD
• Hardeep Dhaliwal, MD, DMD
• Jasonpreet Dhaliwal, OD
• Mannat Kaur Dhillon
• Christina Lynn Diamonti, PSYD
• Karem Diaz

• Dentist in Issaquah, WA
• Providers in Issaquah, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2024; 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.