Provider Demographics
NPI:1841607934
Name:LUXADENT
Entity Type:Organization
Organization Name:LUXADENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ZOHREH
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLSHANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-530-4202
Mailing Address - Street 1:5115 BUFFALO SPEEDWAY
Mailing Address - Street 2:SUITE: 700
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77005-4211
Mailing Address - Country:US
Mailing Address - Phone:832-530-4202
Mailing Address - Fax:
Practice Address - Street 1:5115 BUFFALO SPEEDWAY
Practice Address - Street 2:SUITE: 700
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77005-4211
Practice Address - Country:US
Practice Address - Phone:832-530-4202
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-21
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX21473122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty