Provider Demographics
NPI:1639303233
Name:DENTAL HEALTH ASSOCIATES OF TEXAS, PC.
Entity Type:Organization
Organization Name:DENTAL HEALTH ASSOCIATES OF TEXAS, PC.
Other - Org Name:SIENNA DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:TABATHA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEMKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-540-6078
Mailing Address - Street 1:9201 SIENNA RANCH RD STE 102
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-7098
Mailing Address - Country:US
Mailing Address - Phone:281-778-5330
Mailing Address - Fax:281-778-5350
Practice Address - Street 1:9201 SIENNA RANCH RD STE 102
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-7098
Practice Address - Country:US
Practice Address - Phone:281-778-5330
Practice Address - Fax:281-778-5350
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DENTAL HEALTH ASSOCIATES OF TEXAS, PC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-05-11
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty