Provider Demographics
NPI:1033538301
Name:NANCY ENDARI D.D.S., P.A.
Entity Type:Organization
Organization Name:NANCY ENDARI D.D.S., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:NYOUSA
Authorized Official - Last Name:ENDARI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:409-861-0100
Mailing Address - Street 1:2155 DOWLEN RD
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77706-2534
Mailing Address - Country:US
Mailing Address - Phone:409-861-0100
Mailing Address - Fax:409-861-0105
Practice Address - Street 1:2155 DOWLEN RD
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77706-2534
Practice Address - Country:US
Practice Address - Phone:409-861-0100
Practice Address - Fax:409-861-0105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-15
Last Update Date:2014-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19565261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental