Provider Demographics
NPI:1033890090
Name:DEEPIKA DHAMA, D.D.S.
Entity Type:Organization
Organization Name:DEEPIKA DHAMA, D.D.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEEPIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:DHAMA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:949-774-2139
Mailing Address - Street 1:PO BOX 920050
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75392-0050
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:18102 CULVER DR
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612-2730
Practice Address - Country:US
Practice Address - Phone:949-774-2139
Practice Address - Fax:949-774-2158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-31
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty