Individual provider Active NPI

Pavneet Momi, DDS

  • Dentist
  • Arlington, WA
National Provider Identifier
1760094668
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DE61126699 Issued in WA
Practice address
520 N Olympic Ave
Arlington, WA 98223-1247
Phone
(360) 435-4043
Fax
(360) 435-2344
NPI assigned
Aug 20, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 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 DE61126699 WA Primary

Addresses

Primary practice location

520 N Olympic Ave
Arlington, WA 98223-1247

Mailing address

3909 185TH PL SW
Lynnwood, WA 98037-3813
Phone (206) 335-6770

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DE61126699WAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Pavneet Momi & Rapinder Momi DDS, PLLC CurrentSince Mar 12, 2023 Accepting new patients
Washington Dental Corporation, PC Dentist PastSince Mar 1, 2021 Accepting new patients
Gennadiy Kalvish DDS PLLC PastSince Mar 12, 2023 Accepting new patients

Locations

520 N Olympic Ave
Arlington, WA 98223
Phone (360) 435-4043

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1597881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1760094668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3909 185TH PL SW",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980373813",
            "telephone_number": "206-335-6770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 N OLYMPIC AVE",
            "city": "ARLINGTON",
            "state": "WA",
            "postal_code": "982231247",
            "telephone_number": "360-435-4043",
            "fax_number": "360-435-2344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOMI",
        "first_name": "PAVNEET",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-08-20",
        "last_updated": "2023-03-07",
        "certification_date": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE61126699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.