Provider Demographics
NPI:1962025726
Name:GIRI PALANISWAMY DDS INC.
Entity type:Organization
Organization Name:GIRI PALANISWAMY DDS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GIRIVINOTHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PALANISWAMY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-993-4474
Mailing Address - Street 1:28358 S WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:RANCHO PALOS VERDES
Mailing Address - State:CA
Mailing Address - Zip Code:90275-1434
Mailing Address - Country:US
Mailing Address - Phone:310-547-1128
Mailing Address - Fax:310-547-1120
Practice Address - Street 1:28358 S WESTERN AVE
Practice Address - Street 2:
Practice Address - City:RANCHO PALOS VERDES
Practice Address - State:CA
Practice Address - Zip Code:90275-1434
Practice Address - Country:US
Practice Address - Phone:310-547-1128
Practice Address - Fax:310-547-1120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-27
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental