Provider Demographics
NPI:1669807350
Name:DHIRAJ WARMAN DDS, MD
Entity type:Organization
Organization Name:DHIRAJ WARMAN DDS, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:DHIRAJ
Authorized Official - Middle Name:
Authorized Official - Last Name:WARMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MD
Authorized Official - Phone:352-686-7688
Mailing Address - Street 1:10441 QUALITY DR STE 103
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34609-9649
Mailing Address - Country:US
Mailing Address - Phone:352-686-7688
Mailing Address - Fax:352-683-3160
Practice Address - Street 1:10441 QUALITY DR STE 103
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34609-9649
Practice Address - Country:US
Practice Address - Phone:352-686-7688
Practice Address - Fax:352-683-3160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-12
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN143941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL260742500Medicaid
FLDN14394OtherDENTIST
FL51637Medicare UPIN
FLDN14394OtherDENTIST