Provider Demographics
NPI:1386302743
Name:PITTI, VARUN HIRALAL (BDS, MDS)
Entity type:Individual
Prefix:
First Name:VARUN
Middle Name:HIRALAL
Last Name:PITTI
Suffix:
Gender:M
Credentials:BDS, MDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1790 MERCER PKWY APT 8401
Mailing Address - Street 2:
Mailing Address - City:FARMERS BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:75234-1455
Mailing Address - Country:US
Mailing Address - Phone:201-551-2421
Mailing Address - Fax:
Practice Address - Street 1:410 E PIONEER PKWY STE 100
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75051-4984
Practice Address - Country:US
Practice Address - Phone:972-854-0111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-02
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX38029122300000X, 1223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics
No122300000XDental ProvidersDentist