MEDICARE: THE ENDODONTIC SPECIALISTS, 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	1223P0300X	Periodontics
2	1223E0200X	Endodontics

General Provider Information

NPI Number	:	1720543101
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE ENDODONTIC SPECIALISTS, PLLC

Provider Business Mailing Address
First Line	:	4880 N PRESIDENT GEORGE BUSH HWY STE 102
Second Line	:
City	:	GARLAND
State	:	TX
Zip	:	75040-2742
Country	:	US
Telephone Number	:	504-261-6969
Fax Number	:

Provider Business Practice Location Address
First Line	:	4880 N PRESIDENT GEORGE BUSH HWY STE 102
Second Line	:
City	:	GARLAND
State	:	TX
Zip	:	75040-2742
Country	:	US
Telephone Number	:	972-496-0164
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MAHEEB JAOUNI
Credential	:
Telephone Number	:	504-261-6969

Provider Enumeration Date	:	02/09/2019
Last Update Date	:	03/16/2026

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