Provider Demographics
NPI:1679185532
Name:BELLO DENTISTRY PLLC
Entity type:Organization
Organization Name:BELLO DENTISTRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:ELSAKR
Authorized Official - Suffix:
Authorized Official - Credentials:DMS
Authorized Official - Phone:346-415-0400
Mailing Address - Street 1:8505 GULF FWY STE D
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77017-5043
Mailing Address - Country:US
Mailing Address - Phone:346-415-0400
Mailing Address - Fax:
Practice Address - Street 1:8505 GULF FWY STE D
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77017-5043
Practice Address - Country:US
Practice Address - Phone:346-415-0400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-20
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1255684999Medicaid