Provider Demographics
NPI:1386184240
Name:AVANI SARVAIYA DDS INC
Entity Type:Organization
Organization Name:AVANI SARVAIYA DDS INC
Other - Org Name:ORANGE SKY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AVANI
Authorized Official - Middle Name:
Authorized Official - Last Name:SARVAIYA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-289-5009
Mailing Address - Street 1:1916 N TUSTIN ST
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92865-4644
Mailing Address - Country:US
Mailing Address - Phone:714-289-5009
Mailing Address - Fax:
Practice Address - Street 1:1916 N TUSTIN ST
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92865-4644
Practice Address - Country:US
Practice Address - Phone:714-289-5009
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-27
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA565211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty