Provider Demographics
NPI:1578091211
Name:ESTHETIC DENTAL INC
Entity Type:Organization
Organization Name:ESTHETIC DENTAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:YEFIM
Authorized Official - Middle Name:
Authorized Official - Last Name:ARANBAYEV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-945-5100
Mailing Address - Street 1:5530 NEW FALLS RD
Mailing Address - Street 2:
Mailing Address - City:LEVITTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19056-3102
Mailing Address - Country:US
Mailing Address - Phone:215-945-5100
Mailing Address - Fax:
Practice Address - Street 1:5530 NEW FALLS RD
Practice Address - Street 2:
Practice Address - City:LEVITTOWN
Practice Address - State:PA
Practice Address - Zip Code:19056-3102
Practice Address - Country:US
Practice Address - Phone:215-945-5100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS038565261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental