MEDICARE: DR. ABDOUL R KORONI DDS

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	19896	TX
2	1223E0200X	Endodontics	19896	TX

General Provider Information

NPI Number	:	1013137967
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ABDOUL R KORONI DDS

Provider Business Mailing Address
First Line	:	305 OAK HOLLOW DR
Second Line	:
City	:	LEAGUE CITY
State	:	TX
Zip	:	77573-1767
Country	:	US
Telephone Number	:	281-338-0374
Fax Number	:

Provider Business Practice Location Address
First Line	:	4023 GULF ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77087-4723
Country	:	US
Telephone Number	:	713-645-8822
Fax Number	:	713-649-6023

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/25/2007
Last Update Date	:	02/05/2026

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