Provider Demographics
NPI:1679950851
Name:LAXMI SAI DENTAL PLLC
Entity type:Organization
Organization Name:LAXMI SAI DENTAL PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MAHESH
Authorized Official - Middle Name:
Authorized Official - Last Name:GONDI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:214-307-4755
Mailing Address - Street 1:300 S COTTONWOOD DR
Mailing Address - Street 2:SUITE-B
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-5751
Mailing Address - Country:US
Mailing Address - Phone:214-307-4755
Mailing Address - Fax:
Practice Address - Street 1:300 S COTTONWOOD DRIVE
Practice Address - Street 2:SUITE B
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080
Practice Address - Country:US
Practice Address - Phone:214-307-4755
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-27
Last Update Date:2015-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX222131223G0001X
TX249421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1306909080OtherNPI
TX1871726943OtherNPI