MEDICARE: DENTISTRY OF THE OAKS, 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	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1992291413
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DENTISTRY OF THE OAKS, PLLC

Provider Business Mailing Address
First Line	:	1717 W 34TH ST STE 450
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77018-6256
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1717 W 34TH ST STE 450
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77018-6256
Country	:	US
Telephone Number	:	832-372-8527
Fax Number	:

Authorized Official
Title or Position	:	DENTIST/OWNER
Name	:	DR. LINDSEY LUANN WENDT
Credential	:	DDS
Telephone Number	:	832-372-8527

Provider Enumeration Date	:	07/09/2018
Last Update Date	:	07/09/2018

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