Healthcare Provider Details
I. General information
NPI: 1891471959
Provider Name (Legal Business Name): DOMINIQUE ANGELE ANGIBEAU DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/23/2023
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2701 PEARLAND PKWY STE 120
PEARLAND TX
77581-5946
US
IV. Provider business mailing address
3407 S HALLS POINT CT
MISSOURI CITY TX
77459-6578
US
V. Phone/Fax
- Phone: 281-435-2818
- Fax:
- Phone: 281-435-2818
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 122300000X |
| Taxonomy | Dentist |
| License Number | 40584 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: