Provider Demographics
NPI:1023847902
Name:BLESSED DENTAL SPECIALISTS PLLC
Entity type:Organization
Organization Name:BLESSED DENTAL SPECIALISTS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARIQ
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:443-570-4055
Mailing Address - Street 1:1355 E LEAGUE CITY PKWY STE 500
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-7096
Mailing Address - Country:US
Mailing Address - Phone:346-358-3592
Mailing Address - Fax:
Practice Address - Street 1:1355 E LEAGUE CITY PKWY STE 500
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-7096
Practice Address - Country:US
Practice Address - Phone:346-358-3592
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-30
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty