Healthcare Provider Details

I. General information

NPI: 1235477126
Provider Name (Legal Business Name): ALI DANESHMAND DDS., PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2013
Last Update Date: 01/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5177 RICHMOND AVE STE 150
HOUSTON TX
77056-6725
US

IV. Provider business mailing address

5177 RICHMOND AVE STE 150
HOUSTON TX
77056-6725
US

V. Phone/Fax

Practice location:
  • Phone: 713-960-9926
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number24270
License Number StateTX

VIII. Authorized Official

Name: ALI DANESHMAND
Title or Position: OWNER
Credential: DDS
Phone: 713-960-9926