Provider Demographics
NPI:1962660746
Name:BORYS VARNAVA DDS INC
Entity Type:Organization
Organization Name:BORYS VARNAVA DDS INC
Other - Org Name:B & T DENTAL
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/ DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BORYS
Authorized Official - Middle Name:
Authorized Official - Last Name:VARNAVA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:408-523-1400
Mailing Address - Street 1:660 S BERNARDO AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94087-1064
Mailing Address - Country:US
Mailing Address - Phone:408-523-1400
Mailing Address - Fax:
Practice Address - Street 1:660 S BERNARDO AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94087-1064
Practice Address - Country:US
Practice Address - Phone:408-523-1400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-28
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA470031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB47003-01OtherDENTICAL