Provider Demographics
NPI:1346623113
Name:ADAMEK, DUSTIN JACOB (DDS)
Entity type:Individual
Prefix:DR
First Name:DUSTIN
Middle Name:JACOB
Last Name:ADAMEK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10200 BOULDER LN
Mailing Address - Street 2:SUITE 300
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78726-1812
Mailing Address - Country:US
Mailing Address - Phone:512-362-7130
Mailing Address - Fax:
Practice Address - Street 1:6830 E SAM HOUSTON PKWY N
Practice Address - Street 2:SUITE 100
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77049-7301
Practice Address - Country:US
Practice Address - Phone:713-451-8845
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-29
Last Update Date:2017-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31105122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist