Provider Demographics
NPI:1033628714
Name:EVERSHINE DENTAL PLLC
Entity Type:Organization
Organization Name:EVERSHINE DENTAL PLLC
Other - Org Name:BEST DENTAL CARE @ TYLER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SACHIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KOCHAREKAR
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:575-268-8648
Mailing Address - Street 1:3310 S SOUTHWEST LOOP 323
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75701-9236
Mailing Address - Country:US
Mailing Address - Phone:903-593-3333
Mailing Address - Fax:
Practice Address - Street 1:3310 S SOUTHWEST LOOP 323
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-9236
Practice Address - Country:US
Practice Address - Phone:903-593-3333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32777261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3506636-04Medicaid