Provider Demographics
NPI:1164172763
Name:HI5 SMILES DENTAL
Entity Type:Organization
Organization Name:HI5 SMILES DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RAMON
Authorized Official - Middle Name:
Authorized Official - Last Name:MORALES-ABREU
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:713-364-8304
Mailing Address - Street 1:19732 STATE HIGHWAY 249
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-3102
Mailing Address - Country:US
Mailing Address - Phone:713-364-8304
Mailing Address - Fax:
Practice Address - Street 1:19732 STATE HIGHWAY 249
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-3102
Practice Address - Country:US
Practice Address - Phone:713-364-8304
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-25
Last Update Date:2022-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3413346Medicaid