Provider Demographics
NPI:1700696739
Name:DENTIST IN AUSTIN LLC
Entity type:Organization
Organization Name:DENTIST IN AUSTIN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SUNIL
Authorized Official - Middle Name:R
Authorized Official - Last Name:EAMANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-430-4472
Mailing Address - Street 1:2110 W SLAUGHTER LN STE 190
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78748-5997
Mailing Address - Country:US
Mailing Address - Phone:512-430-4472
Mailing Address - Fax:
Practice Address - Street 1:2110 W SLAUGHTER LN STE 190
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78748-5997
Practice Address - Country:US
Practice Address - Phone:512-430-4472
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-11
Last Update Date:2025-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty