MEDICARE: RIVER OAKS DENTISTRY PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1033920715
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RIVER OAKS DENTISTRY PLLC

Provider Business Mailing Address
First Line	:	2036 WESTHEIMER RD STE D
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77098-1573
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2036 WESTHEIMER RD STE D
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77098-1573
Country	:	US
Telephone Number	:	832-859-5066
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. GAZELLE SHABANI
Credential	:	DDS
Telephone Number	:	832-859-5066

Provider Enumeration Date	:	01/14/2025
Last Update Date	:	01/14/2025

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