Provider Demographics
NPI:1417316720
Name:TRINITY LIVINGSTON DENTAL PLLC
Entity Type:Organization
Organization Name:TRINITY LIVINGSTON DENTAL PLLC
Other - Org Name:TRINITY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMJAD
Authorized Official - Middle Name:A
Authorized Official - Last Name:SHEIKH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-781-6009
Mailing Address - Street 1:1601 HIGHWAY 59 LOOP N STE 400
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77351-6687
Mailing Address - Country:US
Mailing Address - Phone:832-474-5406
Mailing Address - Fax:
Practice Address - Street 1:1601 HIGHWAY 59 LOOP N STE 400
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:TX
Practice Address - Zip Code:77351-6687
Practice Address - Country:US
Practice Address - Phone:832-474-5406
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-15
Last Update Date:2016-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX21047122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty