Provider Demographics
NPI:1760804082
Name:SAMANT, PAIVI (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAIVI
Middle Name:
Last Name:SAMANT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4404 NW 36TH AVE
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-7210
Mailing Address - Country:US
Mailing Address - Phone:352-376-5120
Mailing Address - Fax:352-373-6256
Practice Address - Street 1:4404 NW 36TH AVE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-7210
Practice Address - Country:US
Practice Address - Phone:352-376-5120
Practice Address - Fax:352-373-6256
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-07
Last Update Date:2014-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLD168381223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics