Provider Demographics
NPI:1417676800
Name:SARVAIYA DENTAL CORP
Entity Type:Organization
Organization Name:SARVAIYA DENTAL CORP
Other - Org Name:
Other - Org Type:
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:818-257-4978
Mailing Address - Street 1:22951 LOS ALISOS BLVD STE 2
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-2841
Mailing Address - Country:US
Mailing Address - Phone:949-380-9506
Mailing Address - Fax:
Practice Address - Street 1:22951 LOS ALISOS BLVD STE 2
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-2841
Practice Address - Country:US
Practice Address - Phone:949-380-9506
Practice Address - Fax:949-380-9507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-26
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty