Provider Demographics
NPI:1376429126
Name:TEXAS UNIQUE FAMILY DENTAL
Entity type:Organization
Organization Name:TEXAS UNIQUE FAMILY DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:ADETOKUNBOH
Authorized Official - Last Name:IBITOYE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-415-4061
Mailing Address - Street 1:505 W FAIRMONT PKWY STE A
Mailing Address - Street 2:
Mailing Address - City:LA PORTE
Mailing Address - State:TX
Mailing Address - Zip Code:77571-6312
Mailing Address - Country:US
Mailing Address - Phone:281-471-1797
Mailing Address - Fax:
Practice Address - Street 1:505 W FAIRMONT PKWY STE A
Practice Address - Street 2:
Practice Address - City:LA PORTE
Practice Address - State:TX
Practice Address - Zip Code:77571-6312
Practice Address - Country:US
Practice Address - Phone:281-471-1797
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-14
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty