Provider Demographics
NPI:1073736278
Name:ANOOSHIRAVANI, DINA (DMD, MS)
Entity Type:Individual
Prefix:DR
First Name:DINA
Middle Name:
Last Name:ANOOSHIRAVANI
Suffix:
Gender:F
Credentials:DMD, MS
Other - Prefix:DR
Other - First Name:DINA
Other - Middle Name:
Other - Last Name:BRAMIPOUR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD, MS
Mailing Address - Street 1:3196 CHEVY CHASE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77019-3208
Mailing Address - Country:US
Mailing Address - Phone:713-521-7772
Mailing Address - Fax:
Practice Address - Street 1:4900 WOODWAY DR
Practice Address - Street 2:SUITE 910
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77056-1800
Practice Address - Country:US
Practice Address - Phone:713-355-7373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2013-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX199491223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics