Provider Demographics
NPI:1477020675
Name:GUMS AND SMILES FAMILY DENTAL PLLC
Entity Type:Organization
Organization Name:GUMS AND SMILES FAMILY DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:HARDIK
Authorized Official - Middle Name:ASHOKBHI
Authorized Official - Last Name:BHADESHIYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-337-1919
Mailing Address - Street 1:2082 US HWY 183 STE 140
Mailing Address - Street 2:
Mailing Address - City:LEANDER
Mailing Address - State:TX
Mailing Address - Zip Code:78641-1592
Mailing Address - Country:US
Mailing Address - Phone:512-337-1919
Mailing Address - Fax:512-337-8901
Practice Address - Street 1:2082 US HWY 183 STE 140
Practice Address - Street 2:
Practice Address - City:LEANDER
Practice Address - State:TX
Practice Address - Zip Code:78641-1592
Practice Address - Country:US
Practice Address - Phone:512-337-1919
Practice Address - Fax:512-337-8901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-26
Last Update Date:2018-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX29304OtherTEXAS STATE BOARD OF DENTAL EXAMINERS