MEDICARE: SAIAARNA DENTALPLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	24886	TX

General Provider Information

NPI Number	:	1265976831
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAIAARNA DENTALPLLC

Provider Business Mailing Address
First Line	:	664 SW WILSHIRE BLVD
Second Line	:
City	:	BURLESON
State	:	TX
Zip	:	76028-5851
Country	:	US
Telephone Number	:	817-426-3331
Fax Number	:	817-426-3337

Provider Business Practice Location Address
First Line	:	664 SW WILSHIRE BLVD
Second Line	:
City	:	BURLESON
State	:	TX
Zip	:	76028-5851
Country	:	US
Telephone Number	:	817-426-3331
Fax Number	:	817-426-3337

Authorized Official
Title or Position	:	OWNER DENTIST
Name	:	DR. ARCHANA S SHANKARALINGAPPA
Credential	:	DDS
Telephone Number	:	817-426-3331

Provider Enumeration Date	:	12/15/2016
Last Update Date	:	12/15/2016

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