Provider Demographics
NPI:1649744376
Name:NORTHGATE DENTAL PLLC
Entity Type:Organization
Organization Name:NORTHGATE DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:AHMAD
Authorized Official - Middle Name:JUNAID
Authorized Official - Last Name:AKRAM
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:617-331-6477
Mailing Address - Street 1:17111 WALFORD DR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-9400
Mailing Address - Country:US
Mailing Address - Phone:617-331-6477
Mailing Address - Fax:
Practice Address - Street 1:14715 T C JESTER BLVD.
Practice Address - Street 2:SUITE 500
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77068
Practice Address - Country:US
Practice Address - Phone:281-213-5668
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-16
Last Update Date:2019-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1891006854OtherNPI