Provider Demographics
NPI:1629790381
Name:ORCHID DENTAL PLLC
Entity Type:Organization
Organization Name:ORCHID DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RANTI
Authorized Official - Middle Name:
Authorized Official - Last Name:ARYANI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:610-664-1641
Mailing Address - Street 1:5058 CITY AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19131-1441
Mailing Address - Country:US
Mailing Address - Phone:610-664-1641
Mailing Address - Fax:484-930-0058
Practice Address - Street 1:5058 CITY AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19131-1441
Practice Address - Country:US
Practice Address - Phone:610-664-1641
Practice Address - Fax:484-930-0058
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-19
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental