Provider Demographics
NPI:1285005173
Name:SAIVI DENTAL PLLC
Entity Type:Organization
Organization Name:SAIVI DENTAL PLLC
Other - Org Name:SIGNATURE SMILES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/GENERAL DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:NAREN
Authorized Official - Middle Name:KUMAR
Authorized Official - Last Name:MIKKILINENI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:305-219-1668
Mailing Address - Street 1:308 VINE ST
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75039-2847
Mailing Address - Country:US
Mailing Address - Phone:305-219-1668
Mailing Address - Fax:
Practice Address - Street 1:3654 N BELT LINE RD
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062-7805
Practice Address - Country:US
Practice Address - Phone:214-307-4755
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-17
Last Update Date:2015-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24942122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty