Provider Demographics
NPI:1497154629
Name:PINEDA, JOCELYN (RDH)
Entity Type:Individual
Prefix:
First Name:JOCELYN
Middle Name:
Last Name:PINEDA
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8409 COOLIDGE ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77012-3324
Mailing Address - Country:US
Mailing Address - Phone:832-788-7165
Mailing Address - Fax:
Practice Address - Street 1:9113 STELLA LINK RD
Practice Address - Street 2:SUITE C
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77025-3931
Practice Address - Country:US
Practice Address - Phone:713-375-1777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-13
Last Update Date:2014-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19296124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist