Provider Demographics
NPI:1720381338
Name:GIOVANETTI, LISA (DDS)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:GIOVANETTI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14754 MEMORIAL DR STE 100
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-5275
Mailing Address - Country:US
Mailing Address - Phone:281-497-5558
Mailing Address - Fax:
Practice Address - Street 1:14754 MEMORIAL DR STE 100
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-5275
Practice Address - Country:US
Practice Address - Phone:281-497-5558
Practice Address - Fax:281-497-7181
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-21
Last Update Date:2025-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261911223P0700X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics
No1223G0001XDental ProvidersDentistGeneral Practice