MEDICARE: A&B DENTAL PA

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	:	1124223672
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A&B DENTAL PA

Provider Business Mailing Address
First Line	:	12620 WOODFOREST BLVD STE 420A
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77015-3643
Country	:	US
Telephone Number	:	713-637-8000
Fax Number	:	713-637-6558

Provider Business Practice Location Address
First Line	:	12620 WOODFOREST BLVD STE 420A
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77015-3643
Country	:	US
Telephone Number	:	713-637-8000
Fax Number	:	713-637-6558

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. RAVINDRA BHAKTI
Credential	:	D.D.S
Telephone Number	:	713-637-8000

Provider Enumeration Date	:	06/15/2007
Last Update Date	:	08/22/2020

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Directions to “A&B DENTAL PA ” Practice Location

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