Provider Demographics
NPI:1225492655
Name:CAROUSEL NKS DENTAL SERVICES PLLC
Entity Type:Organization
Organization Name:CAROUSEL NKS DENTAL SERVICES PLLC
Other - Org Name:CAROUSEL NKS DENTAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NAZIM
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAHI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:512-744-6000
Mailing Address - Street 1:9411 N LAMAR BLVD STE 120
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78753-4179
Mailing Address - Country:US
Mailing Address - Phone:512-583-9679
Mailing Address - Fax:512-233-0985
Practice Address - Street 1:2237 E RIVERSIDE DR STE 101-C
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78741-3051
Practice Address - Country:US
Practice Address - Phone:512-744-6000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-12
Last Update Date:2016-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty