Provider Demographics
NPI:1669193777
Name:THERADONTICS PLLC
Entity type:Organization
Organization Name:THERADONTICS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GIANG
Authorized Official - Middle Name:H
Authorized Official - Last Name:LE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:949-344-6516
Mailing Address - Street 1:801 WELLS BRANCH PKWY, SUITE 130
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660
Mailing Address - Country:US
Mailing Address - Phone:512-887-7816
Mailing Address - Fax:
Practice Address - Street 1:801 WELLS BRANCH PKWY, SUITE 130
Practice Address - Street 2:
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660
Practice Address - Country:US
Practice Address - Phone:512-887-7816
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-07
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty
No122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX34824OtherDENTIST