Provider Demographics
NPI:1437710332
Name:BAHADUR, SAIKIRAN (DDS)
Entity Type:Individual
Prefix:
First Name:SAIKIRAN
Middle Name:
Last Name:BAHADUR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7225 9TH AVE APT 1310
Mailing Address - Street 2:
Mailing Address - City:PORT ARTHUR
Mailing Address - State:TX
Mailing Address - Zip Code:77642-2094
Mailing Address - Country:US
Mailing Address - Phone:417-619-3131
Mailing Address - Fax:
Practice Address - Street 1:4997 N TWIN CITY HWY
Practice Address - Street 2:
Practice Address - City:PORT ARTHUR
Practice Address - State:TX
Practice Address - Zip Code:77642-5845
Practice Address - Country:US
Practice Address - Phone:417-619-3131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-22
Last Update Date:2019-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX353651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice