Provider Demographics
NPI:1790210292
Name:BALANDRAN, STEVEN SPENSER (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:SPENSER
Last Name:BALANDRAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7500 CAMBRIDGE ST
Mailing Address - Street 2:SUITE 6510
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-2032
Mailing Address - Country:US
Mailing Address - Phone:713-486-4052
Mailing Address - Fax:713-486-4333
Practice Address - Street 1:4185 TECHNOLOGY FOREST BLVD STE 100
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77381-2004
Practice Address - Country:US
Practice Address - Phone:281-370-4034
Practice Address - Fax:281-374-8251
Is Sole Proprietor?:No
Enumeration Date:2017-04-22
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX38331122300000X, 1223S0112X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program