Provider Demographics
NPI:1932982451
Name:RG DENTISTRY PLLC
Entity Type:Organization
Organization Name:RG DENTISTRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROOZBEH
Authorized Official - Middle Name:
Authorized Official - Last Name:GHASEMI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:512-850-3574
Mailing Address - Street 1:5762 SUGAR HILL DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-2112
Mailing Address - Country:US
Mailing Address - Phone:512-850-3574
Mailing Address - Fax:
Practice Address - Street 1:4001 S SAM HOUSTON PKWY E STE 120
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77047-6848
Practice Address - Country:US
Practice Address - Phone:512-850-3574
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-17
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No122300000XDental ProvidersDentistGroup - Multi-Specialty