Provider Demographics
NPI:1457135501
Name:ELIZABETH VARUGHESE DDS INC.
Entity Type:Organization
Organization Name:ELIZABETH VARUGHESE DDS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:RM
Authorized Official - Last Name:VARUGHESE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-522-0400
Mailing Address - Street 1:7990 ORANGETHORPE AVE
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90621-3437
Mailing Address - Country:US
Mailing Address - Phone:714-522-0400
Mailing Address - Fax:
Practice Address - Street 1:7990 ORANGETHORPE AVE
Practice Address - Street 2:
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90621-3437
Practice Address - Country:US
Practice Address - Phone:714-522-0400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-21
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty