Provider Demographics
NPI:1992906804
Name:SEEMA BANSAL D.D.S. AND SUPARNA ASHRANI D.D.S.
Entity type:Organization
Organization Name:SEEMA BANSAL D.D.S. AND SUPARNA ASHRANI D.D.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUPARNA
Authorized Official - Middle Name:R
Authorized Official - Last Name:ASHRANI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:408-225-2201
Mailing Address - Street 1:7174 SANTA TERESA BLVD
Mailing Address - Street 2:ST# A-4
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95139-1350
Mailing Address - Country:US
Mailing Address - Phone:408-225-2201
Mailing Address - Fax:408-225-2206
Practice Address - Street 1:7174 SANTA TERESA BLVD
Practice Address - Street 2:ST# A-4
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95139-1350
Practice Address - Country:US
Practice Address - Phone:408-225-2201
Practice Address - Fax:408-225-2206
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44822122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty