Provider Demographics
NPI:1073997854
Name:DAHIYA, ANKUR (BDS MDS MSD)
Entity type:Individual
Prefix:
First Name:ANKUR
Middle Name:
Last Name:DAHIYA
Suffix:
Gender:M
Credentials:BDS MDS MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12335 HYMEADOW DR
Mailing Address - Street 2:SUITE 250
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78750-1934
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12335 HYMEADOW DR
Practice Address - Street 2:SUITE 250
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750-1934
Practice Address - Country:US
Practice Address - Phone:512-250-5012
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-12
Last Update Date:2015-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX311381223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics