Provider Demographics
NPI:1649303264
Name:BENVA O. LAZAR DMD & BERNA SANAYEI DDS INCORPORATION
Entity type:Organization
Organization Name:BENVA O. LAZAR DMD & BERNA SANAYEI DDS INCORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RAJI
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-274-9554
Mailing Address - Street 1:2929 THE VILLAGES PKWY
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95135-1442
Mailing Address - Country:US
Mailing Address - Phone:408-274-9554
Mailing Address - Fax:408-274-4320
Practice Address - Street 1:2929 THE VILLAGES PKWY
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95135-1442
Practice Address - Country:US
Practice Address - Phone:408-274-9554
Practice Address - Fax:408-274-4320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty