Provider Demographics
NPI:1578195988
Name:MUNAWEERA DENTISTRY PC
Entity Type:Organization
Organization Name:MUNAWEERA DENTISTRY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DILAN
Authorized Official - Middle Name:VIPULA
Authorized Official - Last Name:MUNAWEERA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:702-280-8953
Mailing Address - Street 1:500 DAMONTE RANCH PKWY STE 909
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89521-5911
Mailing Address - Country:US
Mailing Address - Phone:775-432-1775
Mailing Address - Fax:775-507-4009
Practice Address - Street 1:500 DAMONTE RANCH PKWY STE 909
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89521-5911
Practice Address - Country:US
Practice Address - Phone:775-432-1775
Practice Address - Fax:775-507-4009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-05
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental