Provider Demographics
NPI:1609276138
Name:HEMPSTEAD DENTAL, PC
Entity Type:Organization
Organization Name:HEMPSTEAD DENTAL, PC
Other - Org Name:HEMPSTEAD DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER / DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSHMITA
Authorized Official - Middle Name:
Authorized Official - Last Name:RATH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:479-799-5317
Mailing Address - Street 1:641 10TH ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:HEMPSTEAD
Mailing Address - State:TX
Mailing Address - Zip Code:77445-4528
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:641 10TH ST
Practice Address - Street 2:SUITE C
Practice Address - City:HEMPSTEAD
Practice Address - State:TX
Practice Address - Zip Code:77445-4528
Practice Address - Country:US
Practice Address - Phone:479-799-5317
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-03
Last Update Date:2014-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX293151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty