Provider Demographics
NPI:1508315383
Name:SAXENA DENTAL, PLLC
Entity Type:Organization
Organization Name:SAXENA DENTAL, PLLC
Other - Org Name:HOUSE OF SMILES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ADITI
Authorized Official - Middle Name:
Authorized Official - Last Name:SAXENA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:254-680-4450
Mailing Address - Street 1:5610 E CENTRAL TEXAS EXPY
Mailing Address - Street 2:STE 3
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76543-5519
Mailing Address - Country:US
Mailing Address - Phone:254-680-4450
Mailing Address - Fax:
Practice Address - Street 1:5610 E CENTRAL TEXAS EXPY
Practice Address - Street 2:STE 3
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76543-5519
Practice Address - Country:US
Practice Address - Phone:254-680-4450
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-22
Last Update Date:2016-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX308731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty