Provider Demographics
NPI:1528176922
Name:EBRAHIMIAN, AKBAR AGHA (DDS)
Entity type:Individual
Prefix:DR
First Name:AKBAR
Middle Name:AGHA
Last Name:EBRAHIMIAN
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 1:4838 HILLSWICK DR
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-3929
Mailing Address - Country:US
Mailing Address - Phone:281-242-3547
Mailing Address - Fax:
Practice Address - Street 1:5814 NEW TERRITORY BLVD
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-5948
Practice Address - Country:US
Practice Address - Phone:281-277-8787
Practice Address - Fax:281-277-8788
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX189221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice