Provider Demographics
NPI:1922419746
Name:KEEP SMILING PLLC
Entity Type:Organization
Organization Name:KEEP SMILING PLLC
Other - Org Name:BERKSHIRE FAMILY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PRIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:GREWAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-407-5263
Mailing Address - Street 1:4201 MASSACHUSETTS AVE NW
Mailing Address - Street 2:SUITE 1040C
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016-4701
Mailing Address - Country:US
Mailing Address - Phone:925-407-5263
Mailing Address - Fax:
Practice Address - Street 1:4201 MASSACHUSETTS AVE NW
Practice Address - Street 2:SUITE 1040C
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-4701
Practice Address - Country:US
Practice Address - Phone:925-407-5263
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-14
Last Update Date:2014-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDEN1000978122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty