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General NPI Number Information
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NPI Number | 1164231759
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Entity Type | Organization
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Legal Business Name | KATY PARK PEDIATRIC DENTISTRY PLLC
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Dates
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Enumeration Date | 01/07/2025
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | 23027 MORTON RANCH RD STE T
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City | KATY
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State | TX
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Zip | 77449
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Country | US
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Telephone | 281-462-9188
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Fax |
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Provider Business Mailing Address
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Address Line | 5311 KIRBY DR STE 209
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City | HOUSTON
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State | TX
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Zip | 77005-1339
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DOCTOR
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Name | ARYA DAVOODY
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Credential | DDS
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Telephone | 443-253-9970
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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