Dipti Srivastava, PLLC

Primary specialty

DentistTaxonomy code 122300000X

License

DE60034827 Issued in WA

Legal business name

DIPTI SRIVASTAVA, PLLC

Practice address

22619 SE 64TH PL Ste 210
Issaquah, WA 98027-5342

Phone

(425) 369-9116

Fax

(425) 369-8997

NPI assigned

Aug 22, 2016

Organization subpart

No

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

Authorized official

Name

Dipti Srivastava

Title

Dentist

Phone

(425) 369-9116

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1471824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471824000000",
    "number": "1972058709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22619 SE 64TH PL STE 210",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980275342",
            "telephone_number": "425-369-9116",
            "fax_number": "425-369-8997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22619 SE 64TH PL STE 210",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980275342",
            "telephone_number": "425-369-9116",
            "fax_number": "425-369-8997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIPTI SRIVASTAVA, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-22",
        "last_updated": "2016-08-22",
        "status": "A",
        "authorized_official_last_name": "SRIVASTAVA",
        "authorized_official_first_name": "DIPTI",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "425-369-9116"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60034827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Erik Didricksen, DPT
• Laurie Lynne Diem, D.O.
• Bridget Murray Dillon, MA, LMHCA
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• Maurice Lee Doerfler, MD
• Paul Doetsch

• 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 Aug 22, 2016; 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.