MEDICARE: SAMEERA S SOLANKI DDS PLLC

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	122300000X	Dentist	5227	AZ
2	1223G0001X	General Practice Dentistry	6863	AZ

General Provider Information

NPI Number	:	1588983977
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAMEERA S SOLANKI DDS PLLC

Provider Business Mailing Address
First Line	:	6605 N 19TH AVE
Second Line	:	SUITE #C
City	:	PHOENIX
State	:	AZ
Zip	:	85015-1628
Country	:	US
Telephone Number	:	602-242-9077
Fax Number	:	602-246-4660

Provider Business Practice Location Address
First Line	:	6605 N 19TH AVE
Second Line	:	SUITE #C
City	:	PHOENIX
State	:	AZ
Zip	:	85015-1628
Country	:	US
Telephone Number	:	602-242-9077
Fax Number	:	602-246-4660

Authorized Official
Title or Position	:	MEMBER
Name	:	SAMEERA S SOLANKI
Credential	:	DDS
Telephone Number	:	602-242-9077

Provider Enumeration Date	:	05/24/2010
Last Update Date	:	05/24/2010

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