Provider Demographics
NPI:1477125839
Name:TRIVEDI, POOJA (DDS)
Entity Type:Individual
Prefix:
First Name:POOJA
Middle Name:
Last Name:TRIVEDI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:POOJA
Other - Middle Name:
Other - Last Name:KINARIWALA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2000 RICHEY ST
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77502-3332
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:174 YALE ST STE 20
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77007-3745
Practice Address - Country:US
Practice Address - Phone:832-767-2210
Practice Address - Fax:832-767-2489
Is Sole Proprietor?:No
Enumeration Date:2021-07-14
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX381821223G0001X, 122300000X
PADS043278122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice