Provider Demographics
NPI:1992231948
Name:HUMBLE KIDS DENTISTRY
Entity type:Organization
Organization Name:HUMBLE KIDS DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RANA
Authorized Official - Middle Name:
Authorized Official - Last Name:MEHR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-279-7185
Mailing Address - Street 1:13551 WILL CLAYTON PKWY
Mailing Address - Street 2:SUITE #2
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77346-3777
Mailing Address - Country:US
Mailing Address - Phone:281-973-3836
Mailing Address - Fax:
Practice Address - Street 1:13551 WILL CLAYTON PKWY
Practice Address - Street 2:SUITE #2
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77346-3777
Practice Address - Country:US
Practice Address - Phone:281-973-3836
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX29572122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty