MEDICARE: DUDUM DENTAL INC

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	1223E0200X	Endodontics

General Provider Information

NPI Number	:	1548114242
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DUDUM DENTAL INC

Provider Business Mailing Address
First Line	:	1800 WEST LOOP S STE 2000
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77027-3211
Country	:	US
Telephone Number	:	469-324-3242
Fax Number	:

Provider Business Practice Location Address
First Line	:	895 MORAGA RD STE 4
Second Line	:
City	:	LAFAYETTE
State	:	CA
Zip	:	94549-5039
Country	:	US
Telephone Number	:	925-283-2735
Fax Number	:

Authorized Official
Title or Position	:	VP, PAYOR RELATIONS
Name	:	MICHAELA MUNIZ
Credential	:
Telephone Number	:	469-324-3242

Provider Enumeration Date	:	02/21/2026
Last Update Date	:	03/25/2026

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