1588878284 NPI number — DIPALI DAVE DDS INC

Table of content: (NPI 1588878284)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588878284 NPI number — DIPALI DAVE DDS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DIPALI DAVE DDS 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:
DREAM SMILE DENTAL
Provider Other Organization Name Type Code:
5
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:
1588878284
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/20/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
33141 ALVARADO NILES RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
UNION CITY
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94587-3109
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
510-431-5399
Provider Business Mailing Address Fax Number:
510-431-5499

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
33141 ALVARADO NILES ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
UNION CITY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94587-3109
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-431-5399
Provider Business Practice Location Address Fax Number:
510-431-5499
Provider Enumeration Date:
05/10/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
DAVE
Authorized Official First Name:
DIPALI
Authorized Official Middle Name:
P
Authorized Official Title or Position:
OWNER DOCTOR
Authorized Official Telephone Number:
510-431-5399

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  48347 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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