Provider Demographics
NPI:1720796600
Name:BLISSFUL DENTAL, PLLC
Entity Type:Organization
Organization Name:BLISSFUL DENTAL, PLLC
Other - Org Name:BLISS PEDIATRIC DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHANICA
Authorized Official - Middle Name:
Authorized Official - Last Name:VERANUNT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:626-673-1219
Mailing Address - Street 1:2944 MERIDIANA PKWY
Mailing Address - Street 2:UNIT E
Mailing Address - City:ROSHARON
Mailing Address - State:TX
Mailing Address - Zip Code:77583-3385
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2944 MERIDIANA PARKWAY UNIT E
Practice Address - Street 2:
Practice Address - City:ROSHARON
Practice Address - State:TX
Practice Address - Zip Code:77583
Practice Address - Country:US
Practice Address - Phone:281-369-4566
Practice Address - Fax:281-369-4646
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-09
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental