Provider Demographics
NPI:1538626734
Name:STYLISHSMILE.PLLC
Entity type:Organization
Organization Name:STYLISHSMILE.PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:FIRAS
Authorized Official - Middle Name:
Authorized Official - Last Name:BUKAI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:949-449-3949
Mailing Address - Street 1:57 BLUECOAT
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92620-2607
Mailing Address - Country:US
Mailing Address - Phone:949-449-3949
Mailing Address - Fax:
Practice Address - Street 1:2737 DEVONSHIRE PL NW STE A&B
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20008-3479
Practice Address - Country:US
Practice Address - Phone:202-232-1116
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-23
Last Update Date:2019-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty