Provider Demographics
NPI:1942175674
Name:SUMMER IRIS DENTAL PLLC
Entity type:Organization
Organization Name:SUMMER IRIS DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TUAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:703-678-1493
Mailing Address - Street 1:15300 FM 1825 STE 104B
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-3167
Mailing Address - Country:US
Mailing Address - Phone:512-251-4121
Mailing Address - Fax:512-251-3258
Practice Address - Street 1:15300 FM 1825 STE 104B
Practice Address - Street 2:
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-3167
Practice Address - Country:US
Practice Address - Phone:512-251-4121
Practice Address - Fax:512-251-3258
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUMMER IRIS DENTAL PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-10-10
Last Update Date:2025-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty