Provider Demographics
NPI:1336879451
Name:HIGHSTREET DENTAL
Entity Type:Organization
Organization Name:HIGHSTREET DENTAL
Other - Org Name:HIGHSTREET DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SYED
Authorized Official - Middle Name:
Authorized Official - Last Name:IQBAL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:972-563-3529
Mailing Address - Street 1:407 W HIGH ST
Mailing Address - Street 2:
Mailing Address - City:TERRELL
Mailing Address - State:TX
Mailing Address - Zip Code:75160-2517
Mailing Address - Country:US
Mailing Address - Phone:972-563-3529
Mailing Address - Fax:
Practice Address - Street 1:407 W HIGH ST
Practice Address - Street 2:
Practice Address - City:TERRELL
Practice Address - State:TX
Practice Address - Zip Code:75160-2517
Practice Address - Country:US
Practice Address - Phone:972-563-3529
Practice Address - Fax:866-609-3705
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:IQBAL DENTAL OF TERRELL PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-06-13
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty
No1223P0700XDental ProvidersDentistProsthodonticsGroup - Multi-Specialty
No1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty