Provider Demographics
NPI:1629542097
Name:TALSANIA DENTAL PLLC
Entity Type:Organization
Organization Name:TALSANIA DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:SIDDHARTH
Authorized Official - Middle Name:
Authorized Official - Last Name:TALSANIA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:201-962-5555
Mailing Address - Street 1:2626 DAMES LN
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-3531
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:908 AUDELIA RD STE 400
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-5150
Practice Address - Country:US
Practice Address - Phone:972-231-0799
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-18
Last Update Date:2019-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental