Provider Demographics
NPI:1922641042
Name:AMRIT S BASI DMD CORP
Entity Type:Organization
Organization Name:AMRIT S BASI DMD CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AMRIT
Authorized Official - Middle Name:SINGH
Authorized Official - Last Name:BASI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:925-872-3174
Mailing Address - Street 1:437 WAYLAND LOOP
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE
Mailing Address - State:CA
Mailing Address - Zip Code:94550-4187
Mailing Address - Country:US
Mailing Address - Phone:925-872-3174
Mailing Address - Fax:
Practice Address - Street 1:929 N CENTRAL AVE STE D
Practice Address - Street 2:
Practice Address - City:TRACY
Practice Address - State:CA
Practice Address - Zip Code:95376-3965
Practice Address - Country:US
Practice Address - Phone:925-872-3174
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-21
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty