Provider Demographics
NPI:1881717957
Name:SUNEAL NAIK DDS INC
Entity type:Organization
Organization Name:SUNEAL NAIK DDS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SUNEAL
Authorized Official - Middle Name:P
Authorized Official - Last Name:NAIK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:951-789-7123
Mailing Address - Street 1:1035 W RAMSEY ST
Mailing Address - Street 2:SUITE B-2
Mailing Address - City:BANNING
Mailing Address - State:CA
Mailing Address - Zip Code:92220-4400
Mailing Address - Country:US
Mailing Address - Phone:951-922-2322
Mailing Address - Fax:951-922-2319
Practice Address - Street 1:1035 W RAMSEY ST
Practice Address - Street 2:SUITE B-2
Practice Address - City:BANNING
Practice Address - State:CA
Practice Address - Zip Code:92220-4400
Practice Address - Country:US
Practice Address - Phone:951-922-2322
Practice Address - Fax:951-922-2319
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUNEAL NAIK DDS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-04-06
Last Update Date:2008-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD362171223G0001X
CA36217122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty