# DIPTI SRIVASTAVA, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1972058709
- **Authorized official:** DIPTI SRIVASTAVA (DENTIST)
- **Authorized official phone:** (425) 369-9116

## Contact information

- **Practice address:** 22619 SE 64TH PL STE 210, ISSAQUAH, WA 98027-5342
- **Practice address phone:** (425) 369-9116
- **Practice address fax:** (425) 369-8997
- **Mailing address:** 22619 SE 64TH PL STE 210, ISSAQUAH, WA 98027-5342
- **Mailing address phone:** (425) 369-9116
- **Mailing address fax:** (425) 369-8997

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | DE60034827 | WA | Yes |

## Other

- **Enumeration date:** 08/22/2016
- **Last updated:** 08/22/2016