Healthcare Provider Details

I. General information

NPI: 1952717167
Provider Name (Legal Business Name): MOMAL MUNEER UMRANI DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2014
Last Update Date: 03/04/2021
Certification Date: 03/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5404 KENWOOD DR
ROWLETT TX
75089-3104
US

IV. Provider business mailing address

5404 KENWOOD DR
ROWLETT TX
75089-3104
US

V. Phone/Fax

Practice location:
  • Phone: 806-765-2605
  • Fax: 806-687-5957
Mailing address:
  • Phone: 832-766-1090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number30226
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: