Provider Demographics
NPI:1386031375
Name:SAI DENTAL PLLC
Entity Type:Organization
Organization Name:SAI DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KALYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:NADELLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-256-5704
Mailing Address - Street 1:4109 DANCING WATERS RD
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-7071
Mailing Address - Country:US
Mailing Address - Phone:646-256-5704
Mailing Address - Fax:
Practice Address - Street 1:4611 COLUMBIA AVE STE 104
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75226-2304
Practice Address - Country:US
Practice Address - Phone:214-827-8000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-17
Last Update Date:2015-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX248511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty