1912123217 NPI number — A DOSHI DENTAL CORP

Table of content: (NPI 1912123217)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912123217 NPI number — A DOSHI DENTAL CORP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
A DOSHI DENTAL CORP
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:
HIGH SIERRA DENTAL
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:
1912123217
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 5597
Provider Second Line Business Mailing Address:
A DOSHI DENTAL CROP DBA HIGH SIERRA DENTAL
Provider Business Mailing Address City Name:
FRESNO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93755
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
559-224-3110
Provider Business Mailing Address Fax Number:
559-227-7752

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4820 N FIRST ST
Provider Second Line Business Practice Location Address:
#105 A DOSHI DENTAL CORP DBA HIGH SIERRA DENTAL
Provider Business Practice Location Address City Name:
FRESNO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93726
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-224-3110
Provider Business Practice Location Address Fax Number:
559-227-7752
Provider Enumeration Date:
04/17/2007

Additional Information

Authorized Official

Authorized Official Last Name:
DOSHI
Authorized Official First Name:
ABHAY
Authorized Official Middle Name:
N
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
559-224-3110

Provider Taxonomy Codes

  • Taxonomy code: 122300000X , with the licence number:  41602 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 1223G0001X , with the licence number: 41602 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

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

  • Identifier: 523305 . This is a "PIN" identifier . This identifiers is of the category "OTHER".
  • Identifier: G9387401 . This is a "DENTICAL" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com