Provider Demographics
NPI:1043884810
Name:LALANI SQUARED LLC
Entity Type:Organization
Organization Name:LALANI SQUARED LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KHURRAM
Authorized Official - Middle Name:
Authorized Official - Last Name:LALANI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:469-730-0090
Mailing Address - Street 1:4539 LAFAYETTE ST
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-4628
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2585 FAITHON P LUCAS SR BLVD STE 100
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75181-1504
Practice Address - Country:US
Practice Address - Phone:469-730-0090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-17
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental