Provider Demographics
NPI:1811252877
Name:SAMANI, HOOMAN Z (DDS)
Entity type:Individual
Prefix:
First Name:HOOMAN
Middle Name:Z
Last Name:SAMANI
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 1:9070 RESEARCH BLVD
Mailing Address - Street 2:205A
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-7004
Mailing Address - Country:US
Mailing Address - Phone:512-693-9123
Mailing Address - Fax:
Practice Address - Street 1:9070 RESEARCH BLVD
Practice Address - Street 2:205A
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-7004
Practice Address - Country:US
Practice Address - Phone:512-693-9123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-05
Last Update Date:2013-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX280161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice