Provider Demographics
NPI:1851616205
Name:ROSHANAK HAGHSHENAS
Entity Type:Organization
Organization Name:ROSHANAK HAGHSHENAS
Other - Org Name:KATYMILLS DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROSHANAK
Authorized Official - Middle Name:
Authorized Official - Last Name:HAGHSHENAS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-644-5166
Mailing Address - Street 1:2001 KATY MILLS BLVD STE E
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-4880
Mailing Address - Country:US
Mailing Address - Phone:281-644-5166
Mailing Address - Fax:281-644-5165
Practice Address - Street 1:2001 KATY MILLS BLVD STE E
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-4880
Practice Address - Country:US
Practice Address - Phone:281-644-5166
Practice Address - Fax:281-644-5165
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-29
Last Update Date:2010-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX224181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty