Provider Demographics
NPI:1245604222
Name:DESERT VIEW DENTAL PLLC
Entity Type:Organization
Organization Name:DESERT VIEW DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RAHUL
Authorized Official - Middle Name:
Authorized Official - Last Name:KODE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-909-7103
Mailing Address - Street 1:770 E THUNDERBIRD RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85022-5307
Mailing Address - Country:US
Mailing Address - Phone:602-866-9704
Mailing Address - Fax:602-866-9706
Practice Address - Street 1:770 E THUNDERBIRD RD
Practice Address - Street 2:SUITE B
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85022-5307
Practice Address - Country:US
Practice Address - Phone:602-866-9704
Practice Address - Fax:602-866-9706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-13
Last Update Date:2015-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ54791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty