Provider Demographics
NPI:1831645019
Name:H J A DENTAL PLLC
Entity Type:Organization
Organization Name:H J A DENTAL PLLC
Other - Org Name:CYPRESS BEND DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SENAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ABD
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:909-223-4035
Mailing Address - Street 1:200 CYPRESS BEND PKWY STE 3
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:TX
Mailing Address - Zip Code:75407-1118
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:200 CYPRESS BEND PKWY STE 3
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:TX
Practice Address - Zip Code:75407-1118
Practice Address - Country:US
Practice Address - Phone:469-290-6565
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-29
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX300801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty