Provider Demographics
NPI:1255785853
Name:HAMPTON DENTAL PLLC
Entity type:Organization
Organization Name:HAMPTON DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SAI LAVANYA
Authorized Official - Middle Name:
Authorized Official - Last Name:PERAMALA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:302-983-4426
Mailing Address - Street 1:516 S HAMPTON RD
Mailing Address - Street 2:#100
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75208-5621
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8177 PITKIN RD
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-4958
Practice Address - Country:US
Practice Address - Phone:302-983-4426
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-20
Last Update Date:2016-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty