| Doctor Name: | PAVINEE CHOTIWANNAPORN |
| NPI Number: | 1003151606 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | DE60260314 |
| Business Practice Address: | 20225 Bothell Everett Hwy, Unit 622 Bothell, WA - 98012 |
| Business Phone Number: | 3175226723 |
| Business Fax Number: | |
| Mailing Address: | 20225 Bothell Everett Hwy, Unit 622, BOTHELL |
| State: | WA |
| Postal Code: | 98012 |
| Phone Number: | 3175226723 |
| Fax Number: | |
| NPI Enumeration Date: | 12/07/2012 |
| NPI Last Update Date: | 06/20/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1223P0700X |
| License Number: | DE60260314 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Dental Providers |
| Taxonomy Classification: | Dentist |
| Taxonomy Specialization: | Prosthodontics |
| Taxonomy Definition: | That branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes. |