Provider Demographics
NPI:1073965414
Name:REFLECTIONS DENTAL
Entity Type:Organization
Organization Name:REFLECTIONS DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SINA
Authorized Official - Middle Name:
Authorized Official - Last Name:SADEGHI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:434-466-0307
Mailing Address - Street 1:4144 N CENTRAL EXPY
Mailing Address - Street 2:SUITE 1205
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-3140
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4144 N CENTRAL EXPY
Practice Address - Street 2:SUITE 1205
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204-3140
Practice Address - Country:US
Practice Address - Phone:434-466-0307
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-11
Last Update Date:2016-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX30595122300000X
VA0401413881122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty