Provider Demographics
NPI:1629896808
Name:AMAZON DENTAL PLLC
Entity type:Organization
Organization Name:AMAZON DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CXO
Authorized Official - Prefix:MR
Authorized Official - First Name:AZIM
Authorized Official - Middle Name:DENTAL PLLC DBA ASHA
Authorized Official - Last Name:TIRMIZI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-838-7009
Mailing Address - Street 1:6201 S CUSTER RD STE 600
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-3401
Mailing Address - Country:US
Mailing Address - Phone:972-838-7009
Mailing Address - Fax:972-957-5882
Practice Address - Street 1:6201 S CUSTER RD STE 600
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-3401
Practice Address - Country:US
Practice Address - Phone:972-838-7009
Practice Address - Fax:972-957-5882
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMAZON DENTAL PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-09-27
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty