Provider Demographics
NPI:1811401037
Name:AYANA L CARTWRIGHT DDS PLLC
Entity Type:Organization
Organization Name:AYANA L CARTWRIGHT DDS PLLC
Other - Org Name:KATY DENTAL LOFT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AYANA
Authorized Official - Middle Name:LORRAINE
Authorized Official - Last Name:CARTWRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-402-3351
Mailing Address - Street 1:2902 ASHFORD TRAIL DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-2127
Mailing Address - Country:US
Mailing Address - Phone:248-372-1209
Mailing Address - Fax:
Practice Address - Street 1:94 W GRAND PARKWAY S
Practice Address - Street 2:SUITE 240
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494
Practice Address - Country:US
Practice Address - Phone:281-402-3351
Practice Address - Fax:281-402-3352
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-27
Last Update Date:2017-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX279361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1407101942OtherNPI TYPE 1