Healthcare Provider Details

I. General information

NPI: 1992130975
Provider Name (Legal Business Name): SOLMAZ EFTEKHARI D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2013
Last Update Date: 04/07/2021
Certification Date: 04/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 WESTHEIMER RD STE 630
HOUSTON TX
77056-5619
US

IV. Provider business mailing address

5000 WESTHEIMER RD STE 630
HOUSTON TX
77056-5619
US

V. Phone/Fax

Practice location:
  • Phone: 713-255-0780
  • Fax: 713-255-0781
Mailing address:
  • Phone: 713-255-0780
  • Fax: 713-255-0781

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number28954
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: