MEDICARE: UNIQUE DENTAL

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	20630	TX
2	1223G0001X	General Practice Dentistry	21680	TX
3	1223G0001X	General Practice Dentistry	22493	TX

General Provider Information

NPI Number	:	1194829473
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIQUE DENTAL

Provider Business Mailing Address
First Line	:	9733 WESTHEIMER RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77043
Country	:	US
Telephone Number	:	713-952-6161
Fax Number	:	713-952-9105

Provider Business Practice Location Address
First Line	:	5438 NORTH FREEWAY
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77076
Country	:	US
Telephone Number	:	713-697-9100
Fax Number	:	713-697-9105

Authorized Official
Title or Position	:	TREASURER
Name	:	MR. NADER NADERI
Credential	:
Telephone Number	:	713-952-6161

Provider Enumeration Date	:	09/08/2006
Last Update Date	:	08/22/2020

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Directions to “UNIQUE DENTAL ” Practice Location

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