Provider Demographics
NPI:1407385792
Name:AFFORDABLE DENTIST
Entity Type:Organization
Organization Name:AFFORDABLE DENTIST
Other - Org Name:AFFORDABLE DENTIST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAVI
Authorized Official - Middle Name:CHANDER
Authorized Official - Last Name:OBEROI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:407-678-3330
Mailing Address - Street 1:3228 W STATE ROAD 426 STE 1000
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-8674
Mailing Address - Country:US
Mailing Address - Phone:407-678-3330
Mailing Address - Fax:407-960-3711
Practice Address - Street 1:3228, W STATE ROAD 426,
Practice Address - Street 2:SUITE 1000
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765
Practice Address - Country:US
Practice Address - Phone:407-678-3330
Practice Address - Fax:407-960-3711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN146401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty