Provider Demographics
NPI:1114295862
Name:TRINITY CLEVLAND DENTAL PLLC
Entity Type:Organization
Organization Name:TRINITY CLEVLAND DENTAL PLLC
Other - Org Name:TRINITY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMJAD
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEIKH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-520-3880
Mailing Address - Street 1:106 TRULY PLZ
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TX
Mailing Address - Zip Code:77327-4889
Mailing Address - Country:US
Mailing Address - Phone:281-520-3880
Mailing Address - Fax:
Practice Address - Street 1:106 TRULY PLZ
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TX
Practice Address - Zip Code:77327-4889
Practice Address - Country:US
Practice Address - Phone:281-520-3880
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-09
Last Update Date:2011-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX210471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty