Provider Demographics
NPI:1831971605
Name:SMILES OF DFW PLLC
Entity type:Organization
Organization Name:SMILES OF DFW PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RINI
Authorized Official - Middle Name:
Authorized Official - Last Name:BAVISHI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:201-920-2457
Mailing Address - Street 1:2600 LAUREL VALLEY LN
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76006-4018
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3550 E BROAD ST
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-6892
Practice Address - Country:US
Practice Address - Phone:201-920-2457
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-17
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental