Provider Demographics
NPI:1003300393
Name:NAPA DENTAL MANAGEMENT LLC
Entity Type:Organization
Organization Name:NAPA DENTAL MANAGEMENT LLC
Other - Org Name:NAPA FAMILY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:KARTIK
Authorized Official - Middle Name:
Authorized Official - Last Name:ANTANI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:848-565-5070
Mailing Address - Street 1:10820 COMANCHE RD NE STE D
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-3983
Mailing Address - Country:US
Mailing Address - Phone:505-323-7700
Mailing Address - Fax:
Practice Address - Street 1:10820 COMANCHE RD NE STE D
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-3983
Practice Address - Country:US
Practice Address - Phone:505-323-7700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-19
Last Update Date:2023-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDentalGroup - Multi-Specialty