Provider Demographics
NPI:1740927292
Name:FM DENTISTRY & ORTHODONTICS
Entity type:Organization
Organization Name:FM DENTISTRY & ORTHODONTICS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:FATEMEH
Authorized Official - Middle Name:
Authorized Official - Last Name:MOHANDES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-454-3152
Mailing Address - Street 1:6420 FM 1463 RD
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-3814
Mailing Address - Country:US
Mailing Address - Phone:281-454-3152
Mailing Address - Fax:
Practice Address - Street 1:6420 FM 1463 RD STE 200
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-3813
Practice Address - Country:US
Practice Address - Phone:281-454-3152
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-17
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty