Provider Demographics
NPI:1841015344
Name:SAJINI CHANDRAN DMD PLLC
Entity type:Organization
Organization Name:SAJINI CHANDRAN DMD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAJINI
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANDRAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-765-9355
Mailing Address - Street 1:1847 FALSTAFF
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-2543
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:203 N LOOP 1604 W STE 101
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-1086
Practice Address - Country:US
Practice Address - Phone:210-939-0488
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-19
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental