Provider Demographics
NPI:1811715394
Name:DR.SWATHI UPADHYAYA DENTAL CORPORATION
Entity type:Organization
Organization Name:DR.SWATHI UPADHYAYA DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SWATHI
Authorized Official - Middle Name:
Authorized Official - Last Name:UPADHYAYA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:408-718-4784
Mailing Address - Street 1:1625 TULLY RD STE E
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95122-2541
Mailing Address - Country:US
Mailing Address - Phone:408-272-2424
Mailing Address - Fax:
Practice Address - Street 1:1625 TULLY RD STE E
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95122-2541
Practice Address - Country:US
Practice Address - Phone:408-272-2424
Practice Address - Fax:408-272-0958
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-02
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty