Provider Demographics
NPI:1134409584
Name:THE ENDODONTIC SPECIALISTS, PLLC
Entity type:Organization
Organization Name:THE ENDODONTIC SPECIALISTS, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MAHEEB
Authorized Official - Middle Name:
Authorized Official - Last Name:JAOUNI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:504-261-6969
Mailing Address - Street 1:4880 N PRESIDENT GEORGE BUSH HIGHWAY
Mailing Address - Street 2:SUITE 102
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75040
Mailing Address - Country:US
Mailing Address - Phone:972-496-0164
Mailing Address - Fax:972-396-6270
Practice Address - Street 1:4170 LAVON DR
Practice Address - Street 2:STE. 164
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75040-2926
Practice Address - Country:US
Practice Address - Phone:972-496-0164
Practice Address - Fax:972-396-6270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-17
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX256001223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty