MEDICARE: CONNECT DENTAL SPECIALISTS, PLLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	122300000X	Dentist
2	1223E0200X	Endodontics
3	1223P0221X	Pediatric Dentistry
4	1223P0300X	Periodontics
5	1223P0700X	Prosthodontics
6	1223S0112X	Oral and Maxillofacial Surgery (Dentist)
7	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry
8	124Q00000X	Dental Hygienist
9	126900000X	Dental Laboratory Technician
10	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1235532813
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CONNECT DENTAL SPECIALISTS, PLLC

Provider Business Mailing Address
First Line	:	2902 N SHEPHERD DR UNIT C
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77008-2296
Country	:	US
Telephone Number	:	713-230-8350
Fax Number	:

Provider Business Practice Location Address
First Line	:	2902 N SHEPHERD DR UNIT C
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77008-2296
Country	:	US
Telephone Number	:	713-230-8350
Fax Number	:

Authorized Official
Title or Position	:	DENTIST
Name	:	AURELIJA GALANIS
Credential	:
Telephone Number	:	832-213-7721

Provider Enumeration Date	:	09/26/2014
Last Update Date	:	07/05/2022

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