Provider Demographics
NPI:1992102396
Name:SMILERITE FAMILY DENTISTRY
Entity type:Organization
Organization Name:SMILERITE FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR
Authorized Official - Prefix:DR
Authorized Official - First Name:PRAMEELA
Authorized Official - Middle Name:RANI
Authorized Official - Last Name:BHUPATIRAJU
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:972-233-1906
Mailing Address - Street 1:11909 PRESTON RD
Mailing Address - Street 2:260
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-2746
Mailing Address - Country:US
Mailing Address - Phone:972-233-1906
Mailing Address - Fax:972-720-8044
Practice Address - Street 1:11909 PRESTON RD
Practice Address - Street 2:260
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2746
Practice Address - Country:US
Practice Address - Phone:972-233-1906
Practice Address - Fax:972-720-8044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-01
Last Update Date:2014-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX224981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty