Healthcare Provider Details

I. General information

NPI: 1245251461
Provider Name (Legal Business Name): SAINI ORTHODONTICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10776 HICKORY RIDGE RD
COLUMBIA MD
21044-3646
US

IV. Provider business mailing address

10776 HICKORY RIDGE RD
COLUMBIA MD
21044-3646
US

V. Phone/Fax

Practice location:
  • Phone: 410-730-1255
  • Fax: 410-997-5007
Mailing address:
  • Phone: 410-730-1255
  • Fax: 410-997-5007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number04869
License Number StateMD

VIII. Authorized Official

Name: MS. ANNA M STANLEY
Title or Position: ADMIN
Credential:
Phone: 410-730-1255