Provider Demographics
NPI:1790129906
Name:COMFORT SMILES PLLC
Entity Type:Organization
Organization Name:COMFORT SMILES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEEPTI
Authorized Official - Middle Name:
Authorized Official - Last Name:NAMINENI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:646-241-4964
Mailing Address - Street 1:8803 RODEO DR
Mailing Address - Street 2:APT 103
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-4510
Mailing Address - Country:US
Mailing Address - Phone:646-241-4964
Mailing Address - Fax:
Practice Address - Street 1:216 DALTON DR
Practice Address - Street 2:
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-4414
Practice Address - Country:US
Practice Address - Phone:201-299-7257
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-18
Last Update Date:2013-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX279451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty