Provider Demographics
NPI:1710597711
Name:ASTHANA, SAMARTH (DDS)
Entity Type:Individual
Prefix:DR
First Name:SAMARTH
Middle Name:
Last Name:ASTHANA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6280 MCNEIL DR APT 1411
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78729-6911
Mailing Address - Country:US
Mailing Address - Phone:832-865-7436
Mailing Address - Fax:
Practice Address - Street 1:15550 INTERSTATE 35 STE 110
Practice Address - Street 2:
Practice Address - City:BUDA
Practice Address - State:TX
Practice Address - Zip Code:78610-3887
Practice Address - Country:US
Practice Address - Phone:512-265-8427
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-04
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX363861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice