Provider Demographics
NPI:1508944893
Name:TABRIZI, MATT M (DDS)
Entity Type:Individual
Prefix:
First Name:MATT
Middle Name:M
Last Name:TABRIZI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3425 HIGHWAY 6
Mailing Address - Street 2:STE 108
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-4512
Mailing Address - Country:US
Mailing Address - Phone:281-494-2626
Mailing Address - Fax:281-494-4241
Practice Address - Street 1:3425 HIGHWAY 6
Practice Address - Street 2:STE 108
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-4512
Practice Address - Country:US
Practice Address - Phone:281-494-2626
Practice Address - Fax:281-494-4241
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX171661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice