1770715740 NPI number — RITU PUNIA (DMD)

Table of content: RITU PUNIA (DMD) (NPI 1770715740)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770715740 NPI number — RITU PUNIA (DMD)

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PUNIA
Provider First Name:
RITU
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
(DMD)
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1770715740
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/26/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5851 LONG PRAIRIE RD
Provider Second Line Business Mailing Address:
STE 101
Provider Business Mailing Address City Name:
FLOWER MOUND
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75028-5635
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-539-7252
Provider Business Mailing Address Fax Number:
972-692-5144

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5851 LONG PRAIRIE RD
Provider Second Line Business Practice Location Address:
STE 101
Provider Business Practice Location Address City Name:
FLOWER MOUND
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75028-5635
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-539-7252
Provider Business Practice Location Address Fax Number:
972-692-5144
Provider Enumeration Date:
08/10/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  03738 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 122300000X , with the licence number: 27881 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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