Provider Demographics
NPI:1023559689
Name:VEENA MADHURE, DDS, INC
Entity Type:Organization
Organization Name:VEENA MADHURE, DDS, INC
Other - Org Name:SMILES 4 ALL DENTAL, DENTAL PRACTICE OF DR. VEENA MADHURE, DDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VEENA
Authorized Official - Middle Name:
Authorized Official - Last Name:MADHURE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:925-523-3864
Mailing Address - Street 1:5720 STONERIDGE MALL RD STE 285
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588-2869
Mailing Address - Country:US
Mailing Address - Phone:925-523-3864
Mailing Address - Fax:
Practice Address - Street 1:5720 STONERIDGE MALL RD STE 285
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-2869
Practice Address - Country:US
Practice Address - Phone:925-523-3864
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-16
Last Update Date:2017-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA504881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty