Provider Demographics
NPI:1629802012
Name:ELITE DENTISTRY & ORTHODONTICS PLLC
Entity type:Organization
Organization Name:ELITE DENTISTRY & ORTHODONTICS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AHMAD
Authorized Official - Middle Name:AIDAN
Authorized Official - Last Name:MOAYYED
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:713-298-0183
Mailing Address - Street 1:13630 HWY 6
Mailing Address - Street 2:SUITE 600
Mailing Address - City:ARCOLA
Mailing Address - State:TX
Mailing Address - Zip Code:77583
Mailing Address - Country:US
Mailing Address - Phone:832-241-5040
Mailing Address - Fax:832-241-5065
Practice Address - Street 1:13630 HWY 6
Practice Address - Street 2:SUITE 600
Practice Address - City:ARCOLA
Practice Address - State:TX
Practice Address - Zip Code:77583
Practice Address - Country:US
Practice Address - Phone:832-241-5040
Practice Address - Fax:832-241-5065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-28
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty