Provider Demographics
NPI:1447745310
Name:PRIYANKA ASSUDANI DDS INC
Entity Type:Organization
Organization Name:PRIYANKA ASSUDANI DDS INC
Other - Org Name:THE SMILE ARTISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PRIYANKA
Authorized Official - Middle Name:
Authorized Official - Last Name:ASSUDANI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:720-375-3149
Mailing Address - Street 1:3831 HUGHES AVE STE 608
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90232-6851
Mailing Address - Country:US
Mailing Address - Phone:301-836-8470
Mailing Address - Fax:
Practice Address - Street 1:3831 HUGHES AVE STE 608
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90232-6851
Practice Address - Country:US
Practice Address - Phone:310-836-8470
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-24
Last Update Date:2018-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA64019122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty