Provider Demographics
NPI:1124901285
Name:PVR DENTAL PLLC
Entity type:Organization
Organization Name:PVR DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:PIYUSH
Authorized Official - Middle Name:
Authorized Official - Last Name:HEDA
Authorized Official - Suffix:
Authorized Official - Credentials:MSC
Authorized Official - Phone:281-746-6050
Mailing Address - Street 1:18307 WESTCAVE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-1121
Mailing Address - Country:US
Mailing Address - Phone:281-746-6050
Mailing Address - Fax:
Practice Address - Street 1:21920 WEST RD
Practice Address - Street 2:STE 300
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433
Practice Address - Country:US
Practice Address - Phone:281-746-6050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-28
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty