Provider Demographics
NPI:1588345375
Name:PORTAL DENTAL PASADENA PLLC
Entity type:Organization
Organization Name:PORTAL DENTAL PASADENA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GABRIELA
Authorized Official - Middle Name:
Authorized Official - Last Name:REINHOLTZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-888-3454
Mailing Address - Street 1:3409 SPENCER HWY
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77504-1107
Mailing Address - Country:US
Mailing Address - Phone:281-888-3454
Mailing Address - Fax:281-888-4118
Practice Address - Street 1:3409 SPENCER HWY
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77504-1107
Practice Address - Country:US
Practice Address - Phone:281-888-3454
Practice Address - Fax:281-888-4118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-26
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty