Provider Demographics
NPI:1588831101
Name:DENTAL EXPRESSIONS, PC
Entity type:Organization
Organization Name:DENTAL EXPRESSIONS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SONAL
Authorized Official - Middle Name:
Authorized Official - Last Name:BHOOT
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:973-223-4041
Mailing Address - Street 1:521 SE 2ND STREET
Mailing Address - Street 2:SUITE B
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64063
Mailing Address - Country:US
Mailing Address - Phone:816-525-7155
Mailing Address - Fax:816-525-7225
Practice Address - Street 1:521 SE 2ND ST
Practice Address - Street 2:SUITE B
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64063-2646
Practice Address - Country:US
Practice Address - Phone:816-525-7155
Practice Address - Fax:816-525-7225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-13
Last Update Date:2013-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2008006050122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty