# SHREE SIDDHIVINAYAK DENTAL LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Scioto Smile Studio
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053128546
- **Authorized official:** DR. KHYATI PATEL DMD (OWNER)
- **Authorized official phone:** (614) 306-1721

## Contact information

- **Practice address:** 4290 HOME RD, SUITE C, D, POWELL, OH 43065
- **Practice address phone:** (614) 306-1721
- **Mailing address:** 4290 HOME RD, SUITE C, D, POWELL, OH 43065
- **Mailing address phone:** (614) 306-1721

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 12/17/2024
- **Last updated:** 12/17/2024