Provider Demographics
NPI:1841455201
Name:WASHINGTON MOBILE DENTISTRY
Entity type:Organization
Organization Name:WASHINGTON MOBILE DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARHONDA
Authorized Official - Middle Name:KAZAN
Authorized Official - Last Name:WASHINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:713-781-3331
Mailing Address - Street 1:8619 RICHMOND AVE
Mailing Address - Street 2:700
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-5684
Mailing Address - Country:US
Mailing Address - Phone:713-781-3331
Mailing Address - Fax:713-781-3336
Practice Address - Street 1:8619 RICHMOND AVE
Practice Address - Street 2:700
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-5684
Practice Address - Country:US
Practice Address - Phone:713-781-3331
Practice Address - Fax:713-781-3336
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-25
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX21169261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental