Provider Demographics
NPI:1952747776
Name:DINODENTAL, PLLC
Entity Type:Organization
Organization Name:DINODENTAL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PUKAR
Authorized Official - Middle Name:B
Authorized Official - Last Name:RAJBHANDARI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:402-321-9054
Mailing Address - Street 1:6421 W 43RD ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77092-4005
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6421 W 43RD ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77092-4005
Practice Address - Country:US
Practice Address - Phone:402-321-9054
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-20
Last Update Date:2013-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX272131223G0001X
TX278771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty