Provider Demographics
NPI:1174655070
Name:SAILAJA S DONTHINENI DDS INC
Entity Type:Organization
Organization Name:SAILAJA S DONTHINENI DDS INC
Other - Org Name:ART OF SMILE FAMILY & COSMETIC DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHEIF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SURESH
Authorized Official - Middle Name:
Authorized Official - Last Name:DONTHINENI
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:415-290-8560
Mailing Address - Street 1:3466 MT DIABLO BLVD
Mailing Address - Street 2:C207
Mailing Address - City:LAFAYETTE
Mailing Address - State:CA
Mailing Address - Zip Code:94549
Mailing Address - Country:US
Mailing Address - Phone:925-299-1504
Mailing Address - Fax:925-299-1514
Practice Address - Street 1:3466 MT DIABLO BLVD
Practice Address - Street 2:C207
Practice Address - City:LAFAYETTE
Practice Address - State:CA
Practice Address - Zip Code:94549
Practice Address - Country:US
Practice Address - Phone:925-299-1504
Practice Address - Fax:925-299-1514
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA465841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty