1508162587 NPI number — ANSARI & SANI DENTAL GROUP INC

Table of content: (NPI 1508162587)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508162587 NPI number — ANSARI & SANI DENTAL GROUP INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ANSARI & SANI DENTAL GROUP INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
THE DENTAL HEALTH CENTER
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1508162587
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/08/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
660 W WINTON AVE
Provider Second Line Business Mailing Address:
INSIDE SEARS
Provider Business Mailing Address City Name:
HAYWARD
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94545-2135
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
510-783-0501
Provider Business Mailing Address Fax Number:
510-732-9079

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
660 W WINTON AVE
Provider Second Line Business Practice Location Address:
INSIDE SEARS
Provider Business Practice Location Address City Name:
HAYWARD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94545-2135
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-783-0501
Provider Business Practice Location Address Fax Number:
510-732-9079
Provider Enumeration Date:
02/08/2011

Additional Information

Authorized Official

Authorized Official Last Name:
ANSARI
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
M
Authorized Official Title or Position:
GM
Authorized Official Telephone Number:
510-783-0501

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com