Provider Demographics
NPI:1588454565
Name:BELLA SMILE PLLC
Entity type:Organization
Organization Name:BELLA SMILE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGERIAL MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BEHROUZ
Authorized Official - Middle Name:
Authorized Official - Last Name:BEHESHTIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:703-655-2747
Mailing Address - Street 1:1317 LONGHORN RANCH DR
Mailing Address - Street 2:
Mailing Address - City:LEANDER
Mailing Address - State:TX
Mailing Address - Zip Code:78641-5136
Mailing Address - Country:US
Mailing Address - Phone:703-655-2747
Mailing Address - Fax:
Practice Address - Street 1:1317 LONGHORN RANCH DR
Practice Address - Street 2:
Practice Address - City:LEANDER
Practice Address - State:TX
Practice Address - Zip Code:78641-5136
Practice Address - Country:US
Practice Address - Phone:703-655-2747
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-12
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty