Provider Demographics
NPI:1205000320
Name:BRIAN L. HOCHSTEIN, DDS., PA.
Entity Type:Organization
Organization Name:BRIAN L. HOCHSTEIN, DDS., PA.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:GUZMAN
Authorized Official - Last Name:MALDONADO
Authorized Official - Suffix:
Authorized Official - Credentials:RDS
Authorized Official - Phone:214-381-0663
Mailing Address - Street 1:2244 S BUCKNER BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75227-8578
Mailing Address - Country:US
Mailing Address - Phone:214-381-0663
Mailing Address - Fax:
Practice Address - Street 1:2244 S BUCKNER BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75227-8578
Practice Address - Country:US
Practice Address - Phone:214-381-0663
Practice Address - Fax:214-381-1429
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-18
Last Update Date:2008-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX169681223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX752380OtherUNITED CONCORDIA
TX84D141OtherBLUECROSS BLUESHIELD
TXU50410OtherUPIN
TX009122501Medicaid