Provider Demographics
NPI:1639844160
Name:CLEVELAND'S FAMILY DENTAL CARE PLLC
Entity Type:Organization
Organization Name:CLEVELAND'S FAMILY DENTAL CARE PLLC
Other - Org Name:CLEVELAND SMILES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:NIRZARI
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:215-859-2450
Mailing Address - Street 1:2500 S MILLBEND DR APT 1201
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-1853
Mailing Address - Country:US
Mailing Address - Phone:215-859-2450
Mailing Address - Fax:
Practice Address - Street 1:429 W SOUTHLINE ST STE 900
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TX
Practice Address - Zip Code:77327-5020
Practice Address - Country:US
Practice Address - Phone:281-593-0600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-16
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDentalGroup - Single Specialty