Provider Demographics
NPI:1356229496
Name:AUSTIN DENTAL ASSOCIATES PLLC
Entity type:Organization
Organization Name:AUSTIN DENTAL ASSOCIATES PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST, OPERATING OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMEH
Authorized Official - Middle Name:OZORIS
Authorized Official - Last Name:GIRGIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-312-8479
Mailing Address - Street 1:14900 N INTERSTATE 35
Mailing Address - Street 2:UNIT 101
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78728-5719
Mailing Address - Country:US
Mailing Address - Phone:512-653-3500
Mailing Address - Fax:512-256-1900
Practice Address - Street 1:14900 N INTERSTATE 35
Practice Address - Street 2:UNIT 101
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78728-5719
Practice Address - Country:US
Practice Address - Phone:512-653-3500
Practice Address - Fax:512-256-1900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-26
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist