Provider Demographics
NPI:1346488814
Name:PAI, KAVITHA (DDS)
Entity Type:Individual
Prefix:DR
First Name:KAVITHA
Middle Name:
Last Name:PAI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 BROADWAY BLVD STE 340
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75043-1570
Mailing Address - Country:US
Mailing Address - Phone:972-864-8119
Mailing Address - Fax:972-864-8119
Practice Address - Street 1:3200 BROADWAY BLVD STE 340
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75043-1570
Practice Address - Country:US
Practice Address - Phone:972-864-8119
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-22
Last Update Date:2013-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX240591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice