Provider Demographics
NPI:1104643451
Name:APURVA DABAK DDS INC
Entity type:Organization
Organization Name:APURVA DABAK DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:APURVA SHREEKANT
Authorized Official - Middle Name:
Authorized Official - Last Name:DABAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-423-9832
Mailing Address - Street 1:1030 HARNESS DR APT 56
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-2256
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:93 ARCH ST
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94062-1401
Practice Address - Country:US
Practice Address - Phone:626-423-9832
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-26
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental