Provider Demographics
NPI:1518685437
Name:LAVADO PAREDES, OMAR ARTURO (DMD)
Entity Type:Individual
Prefix:
First Name:OMAR
Middle Name:ARTURO
Last Name:LAVADO PAREDES
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3030 LBJ FREEWAY
Mailing Address - Street 2:SUITE 1700
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75234
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3030 LYNDON B JOHNSON FWY
Practice Address - Street 2:STE 1700
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75234-2759
Practice Address - Country:US
Practice Address - Phone:972-663-5350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-16
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX388601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice