Healthcare Provider Details
I. General information
NPI: 1417371923
Provider Name (Legal Business Name): YASHASHRI URANKAR DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/05/2014
Last Update Date: 02/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3302 GASTON AVE
DALLAS TX
75246-2013
US
IV. Provider business mailing address
2732 GASTON AVE APT 513
DALLAS TX
75226-2718
US
V. Phone/Fax
- Phone: 214-828-8402
- Fax:
- Phone: 626-399-4490
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 122300000X |
| Taxonomy | Dentist |
| License Number | 27507 |
| License Number State | TX |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223D0001X |
| Taxonomy | Public Health Dentistry |
| License Number | 27507 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: