Provider Demographics
NPI:1043019243
Name:EXQUISITE DENTAL SMILES IV PLLC
Entity type:Organization
Organization Name:EXQUISITE DENTAL SMILES IV PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:MAHERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MOMIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-732-8032
Mailing Address - Street 1:8845 WEST LOOP S STE C
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77096
Mailing Address - Country:US
Mailing Address - Phone:713-732-8032
Mailing Address - Fax:
Practice Address - Street 1:8845 WEST LOOP S STE C
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77096
Practice Address - Country:US
Practice Address - Phone:713-732-8032
Practice Address - Fax:346-226-0887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty