Provider Demographics
NPI:1144409038
Name:PEARLAND DENTAL
Entity Type:Organization
Organization Name:PEARLAND DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:SABETI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-485-7005
Mailing Address - Street 1:3300 E WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77581-4309
Mailing Address - Country:US
Mailing Address - Phone:281-485-7005
Mailing Address - Fax:281-485-7196
Practice Address - Street 1:3300 E WALNUT ST
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77581-4309
Practice Address - Country:US
Practice Address - Phone:281-485-7005
Practice Address - Fax:281-485-7196
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-29
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17300122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1699866657OtherMOHAMMAD SABETI DDS
TX1023239654OtherMONTE MILLER DDS
TX1790902047OtherSAEED AHMADI DDS