Provider Demographics
NPI:1790671121
Name:THE AIRWAY DENTISTS OF TEXAS, PLLC
Entity type:Organization
Organization Name:THE AIRWAY DENTISTS OF TEXAS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATION
Authorized Official - Prefix:
Authorized Official - First Name:JACKIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-703-9486
Mailing Address - Street 1:501 S FRIENDSWOOD DR STE 105
Mailing Address - Street 2:
Mailing Address - City:FRIENDSWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77546-4695
Mailing Address - Country:US
Mailing Address - Phone:281-816-3040
Mailing Address - Fax:
Practice Address - Street 1:8190 BARKER CYPRESS RD STE 200
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-2279
Practice Address - Country:US
Practice Address - Phone:281-703-9468
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TEH AIRWAY DENTISTS OF TEXAS, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-06-13
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty