Provider Demographics
NPI:1538679030
Name:APEX DENTAL INC
Entity Type:Organization
Organization Name:APEX DENTAL INC
Other - Org Name:REACH DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SANGITA
Authorized Official - Middle Name:
Authorized Official - Last Name:VENKATESH
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:770-277-5588
Mailing Address - Street 1:845 SCENIC HWY STE 300
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-7104
Mailing Address - Country:US
Mailing Address - Phone:770-277-5588
Mailing Address - Fax:770-995-0501
Practice Address - Street 1:845 SCENIC HWY STE 300
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-7104
Practice Address - Country:US
Practice Address - Phone:770-277-5588
Practice Address - Fax:770-995-0501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-10
Last Update Date:2017-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
122300000X, 1223G0001X
GA261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No122300000XDental ProvidersDentistGroup - Single Specialty
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDentalGroup - Single Specialty