Provider Demographics
NPI:1497581854
Name:DILEEP DANIVAS PLLC
Entity type:Organization
Organization Name:DILEEP DANIVAS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:DILEEP
Authorized Official - Middle Name:S A
Authorized Official - Last Name:DANIVAS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:520-370-2995
Mailing Address - Street 1:600 SECRET MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27523-8502
Mailing Address - Country:US
Mailing Address - Phone:520-370-2995
Mailing Address - Fax:
Practice Address - Street 1:600 SECRET MEADOW LN
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27523-8502
Practice Address - Country:US
Practice Address - Phone:520-370-2995
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-12
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty