Provider Demographics
NPI:1417468000
Name:TRINITY HUMBLE DENTAL PLLC
Entity Type:Organization
Organization Name:TRINITY HUMBLE DENTAL PLLC
Other - Org Name:TRINITY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMJAD
Authorized Official - Middle Name:AJAZ
Authorized Official - Last Name:SHEIKH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-781-6009
Mailing Address - Street 1:507 N SAM HOUSTON PKWY E STE 565
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77060-4021
Mailing Address - Country:US
Mailing Address - Phone:832-474-5406
Mailing Address - Fax:
Practice Address - Street 1:9455 N SAM HOUSTON PKWY E
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77396-2982
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:2017-10-23
Last Update Date:2017-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX21047122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No122300000XDental ProvidersDentistGroup - Single Specialty