MEDICARE: UNIQUDENTAL

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	17151	TX

General Provider Information

NPI Number	:	1770706491
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIQUDENTAL

Provider Business Mailing Address
First Line	:	5438 NORTH FWY
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77076-4701
Country	:	US
Telephone Number	:	713-697-9100
Fax Number	:	713-697-9105

Provider Business Practice Location Address
First Line	:	5438 NORTH FWY
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77076-4701
Country	:	US
Telephone Number	:	713-697-9100
Fax Number	:	713-697-9105

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MR. NADER NADERI
Credential	:
Telephone Number	:	713-697-9100

Provider Enumeration Date	:	04/11/2007
Last Update Date	:	08/22/2020

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Directions to “UNIQUDENTAL ” Practice Location

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