Provider Demographics
NPI:1336366533
Name:YD GREENLIGHT
Entity Type:Organization
Organization Name:YD GREENLIGHT
Other - Org Name:PARKVIEW DENTAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BLANCA
Authorized Official - Middle Name:
Authorized Official - Last Name:URBINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-691-4300
Mailing Address - Street 1:7333 NORTH FWY
Mailing Address - Street 2:SUITE 300
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77076-1300
Mailing Address - Country:US
Mailing Address - Phone:713-691-4300
Mailing Address - Fax:713-691-4461
Practice Address - Street 1:7333 NORTH FWY
Practice Address - Street 2:SUITE 300
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77076-1300
Practice Address - Country:US
Practice Address - Phone:713-691-4300
Practice Address - Fax:713-691-4461
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22078122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG60155-1OtherCHIPS