Provider Demographics
NPI:1417678822
Name:RAD DENT, PLLC
Entity Type:Organization
Organization Name:RAD DENT, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:LON
Authorized Official - Last Name:TAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:832-364-1593
Mailing Address - Street 1:10786 BELLAIRE BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77072-2745
Mailing Address - Country:US
Mailing Address - Phone:281-494-0900
Mailing Address - Fax:281-495-9162
Practice Address - Street 1:10786 BELLAIRE BLVD STE A
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77072-2745
Practice Address - Country:US
Practice Address - Phone:281-494-0900
Practice Address - Fax:281-495-9162
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-06
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental