Provider Demographics
NPI:1912381807
Name:LORI BAGAI DDS INC
Entity Type:Organization
Organization Name:LORI BAGAI DDS INC
Other - Org Name:SMART SMILE DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:BAGAI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-604-6453
Mailing Address - Street 1:1110 E CHAPMAN AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92866-2139
Mailing Address - Country:US
Mailing Address - Phone:714-744-1242
Mailing Address - Fax:
Practice Address - Street 1:1110 E CHAPMAN AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92866-2139
Practice Address - Country:US
Practice Address - Phone:714-744-1242
Practice Address - Fax:714-744-8102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-10
Last Update Date:2015-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty