Provider Demographics
NPI:1821823378
Name:UNIQUE KIDS PD-LAKE HOUSTON, PLLC
Entity type:Organization
Organization Name:UNIQUE KIDS PD-LAKE HOUSTON, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER-CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ROSHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSHANNEJAD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:832-930-7732
Mailing Address - Street 1:22118 MARKET PLACE DR STE 500
Mailing Address - Street 2:
Mailing Address - City:NEW CANEY
Mailing Address - State:TX
Mailing Address - Zip Code:77357-2165
Mailing Address - Country:US
Mailing Address - Phone:832-930-7732
Mailing Address - Fax:
Practice Address - Street 1:14433 W LAKE HOUSTON PKWY
Practice Address - Street 2:200
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77044
Practice Address - Country:US
Practice Address - Phone:832-930-7732
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-04
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty