Provider Demographics
NPI:1326106048
Name:BEST DENTAL, PC
Entity Type:Organization
Organization Name:BEST DENTAL, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KIRTIBALA
Authorized Official - Middle Name:SAMIR
Authorized Official - Last Name:DESAI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:512-248-8888
Mailing Address - Street 1:1715 S MAYS ST
Mailing Address - Street 2:STE E
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78664-6740
Mailing Address - Country:US
Mailing Address - Phone:512-248-8888
Mailing Address - Fax:512-733-0000
Practice Address - Street 1:1715 S MAYS ST
Practice Address - Street 2:STE E
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-6740
Practice Address - Country:US
Practice Address - Phone:512-248-8888
Practice Address - Fax:512-733-0000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2014-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX184091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1808735-02Medicaid