| Abc Dental | |
|
5751 Blythewood St Ste 100 Houston TX 77021-5402 | |
| (281) 593-3300 | |
| (281) 593-1616 |
| Full Name | Abc Dental |
|---|---|
| Speciality | Dentist |
| Location | 5751 Blythewood St, Houston, Texas |
| Authorized Official Name and Position | Iraj S Jabbary (OWNER) |
| Authorized Official Contact | 7139446800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Abc Dental 1500 Southmore Ave Pasadena TX 77502-1307 Ph: (713) 944-6800 | Abc Dental 5751 Blythewood St Ste 100 Houston TX 77021-5402 Ph: (281) 593-3300 |
| NPI Number | 1013230788 |
|---|---|
| Provider Enumeration Date | 03/09/2010 |
| Last Update Date | 07/29/2022 |
| Medicare PECOS PAC ID | 3779873708 |
|---|---|
| Medicare Enrollment ID | O20160603001224 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013230788 | NPI | - | NPPES |
| 210698101 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 18929 (Texas) | Primary |
| Provider Name | Syeda A Reyes |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1265729321 PECOS PAC ID: 1951692250 Enrollment ID: I20160616001142 |
| Provider Name | Mustafa G Alsafi |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1316321482 PECOS PAC ID: 8022309327 Enrollment ID: I20160616001231 |
| Provider Name | Soujanya Pinnamaneni |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1477700789 PECOS PAC ID: 1052601994 Enrollment ID: I20160616001365 |
| Provider Name | Snigda Goutareddy |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1669796116 PECOS PAC ID: 1153612486 Enrollment ID: I20160616002181 |
| Provider Name | Anju N Mandhani |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1821285065 PECOS PAC ID: 5890088058 Enrollment ID: I20160726000531 |
| Provider Name | Kim Thu Dinh |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1982768511 PECOS PAC ID: 0547554412 Enrollment ID: I20160816001329 |
| Provider Name | Abdirahman Nur |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1972838415 PECOS PAC ID: 1557641305 Enrollment ID: I20161213001411 |
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