Provider Demographics
NPI:1003651753
Name:AREEVA DENTAL LLC
Entity type:Organization
Organization Name:AREEVA DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JESBINA
Authorized Official - Middle Name:
Authorized Official - Last Name:PIYA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:612-747-9282
Mailing Address - Street 1:563 BROADWAY STE 21
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:MA
Mailing Address - Zip Code:02149-3749
Mailing Address - Country:US
Mailing Address - Phone:612-747-9282
Mailing Address - Fax:
Practice Address - Street 1:563 BROADWAY STE 21
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:MA
Practice Address - Zip Code:02149-3749
Practice Address - Country:US
Practice Address - Phone:617-389-4646
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-26
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental