Healthcare Provider Details

I. General information

NPI: 1144568411
Provider Name (Legal Business Name): PEARLAND ENDODONTICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2013
Last Update Date: 03/19/2024
Certification Date: 03/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

56 SUGAR CREEK CENTER BLVD SUITE 275
SUGAR LAND TX
77478-4063
US

IV. Provider business mailing address

56 SUGAR CREEK CENTER BLVD SUITE 275
SUGAR LAND TX
77478-4063
US

V. Phone/Fax

Practice location:
  • Phone: 281-201-2824
  • Fax: 281-201-8126
Mailing address:
  • Phone: 281-201-2824
  • Fax: 281-201-8126

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ASHRAF IBRAHIM HARHASH
Title or Position: ENDODONTIST
Credential: DDS,MSC
Phone: 909-362-2728