Provider Demographics
NPI:1467609404
Name:LAKE POINTE DENTAL AND SPECIALTY
Entity Type:Organization
Organization Name:LAKE POINTE DENTAL AND SPECIALTY
Other - Org Name:LALJI DENTAL P.C.
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AYEEZ
Authorized Official - Middle Name:A
Authorized Official - Last Name:LALJI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-242-4433
Mailing Address - Street 1:4635 SOUTHWEST FWY
Mailing Address - Street 2:SUITE 700
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-7169
Mailing Address - Country:US
Mailing Address - Phone:281-242-4433
Mailing Address - Fax:
Practice Address - Street 1:1437 HIGHWAY 6 SOUTH
Practice Address - Street 2:SUITE 200
Practice Address - City:SUGARLAND
Practice Address - State:TX
Practice Address - Zip Code:77479-3989
Practice Address - Country:US
Practice Address - Phone:281-242-4433
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-21
Last Update Date:2008-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX169171223G0001X
TX211141223P0300X
TX200071223S0112X
TX203051223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty
No1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty