Provider Demographics
NPI:1275128597
Name:OMNI DENTAL STUDIO, PLLC
Entity Type:Organization
Organization Name:OMNI DENTAL STUDIO, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:NATALIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROZENFELD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:862-485-0734
Mailing Address - Street 1:7373 N SCOTTSDALE RD STE D245
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85253-5513
Mailing Address - Country:US
Mailing Address - Phone:480-725-4345
Mailing Address - Fax:
Practice Address - Street 1:7373 N SCOTTSDALE RD STE D245
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85253-5513
Practice Address - Country:US
Practice Address - Phone:480-725-4345
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-08
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental