Provider Demographics
NPI:1588983977
Name:SAMEERA S SOLANKI DDS PLLC
Entity type:Organization
Organization Name:SAMEERA S SOLANKI DDS PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SAMEERA
Authorized Official - Middle Name:S
Authorized Official - Last Name:SOLANKI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:602-242-9077
Mailing Address - Street 1:6605 N 19TH AVE
Mailing Address - Street 2:SUITE #C
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85015-1628
Mailing Address - Country:US
Mailing Address - Phone:602-242-9077
Mailing Address - Fax:602-246-4660
Practice Address - Street 1:6605 N 19TH AVE
Practice Address - Street 2:SUITE #C
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85015-1628
Practice Address - Country:US
Practice Address - Phone:602-242-9077
Practice Address - Fax:602-246-4660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-24
Last Update Date:2010-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5227122300000X
AZ68631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No122300000XDental ProvidersDentistGroup - Multi-Specialty