Individual provider Active NPI

Sanjna Samir Mehta, DMD

  • Dentist
  • Seattle, WA
National Provider Identifier
1659060044
Registry record updated May 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DE61416718 Issued in WA
Practice address
1732 Broadway Unit 101
Seattle, WA 98122-2621
Phone
(484) 340-8240
NPI assigned
May 2, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DE61416718 WA Primary

Addresses

Primary practice location

1732 Broadway Unit 101
Seattle, WA 98122-2621

Mailing address

4744 12TH Ave NE Apt 512
Seattle, WA 98105-4695
Phone (484) 340-8240

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230712003856 WA Order and Referring Only - DentistPractitioner - Dentist 6901266782

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DE61416718WAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1682985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682985600000",
    "number": "1659060044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4744 12TH AVE NE APT 512",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981054695",
            "telephone_number": "484-340-8240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1732 BROADWAY UNIT 101",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981222621",
            "telephone_number": "484-340-8240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHTA",
        "first_name": "SANJNA",
        "middle_name": "SAMIR",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-02",
        "last_updated": "2023-05-02",
        "certification_date": "2023-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE61416718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.