Provider Demographics
NPI:1154068237
Name:JOSEPH, TEMILOLA (DDS)
Entity type:Individual
Prefix:
First Name:TEMILOLA
Middle Name:
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1950 W GRAY ST STE 6
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77019-4807
Mailing Address - Country:US
Mailing Address - Phone:713-487-5827
Mailing Address - Fax:
Practice Address - Street 1:1950 W GRAY ST STE 6
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77019-4807
Practice Address - Country:US
Practice Address - Phone:713-487-5827
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-19
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX379221223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist