Provider Demographics
NPI:1497865703
Name:BRIGHTEN DENTAL, PLLC
Entity Type:Organization
Organization Name:BRIGHTEN DENTAL, PLLC
Other - Org Name:DBA: WESTWOOD DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:INSURANCE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:FAYE
Authorized Official - Middle Name:
Authorized Official - Last Name:JAMNEJAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-722-8400
Mailing Address - Street 1:1454 CAMPBELL RD.,
Mailing Address - Street 2:STE 200
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77055-4604
Mailing Address - Country:US
Mailing Address - Phone:713-722-8400
Mailing Address - Fax:713-722-8441
Practice Address - Street 1:1454 CAMPBELL RD.,
Practice Address - Street 2:STE 100
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-4604
Practice Address - Country:US
Practice Address - Phone:713-722-8400
Practice Address - Fax:713-461-1152
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX237191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG60189Other02
TXG60189Other03
TXG60189Other04
TXG60189Other01
TX009830301Medicaid