Olive Dental PLLC

Primary specialty

DentistTaxonomy code 122300000X

License

31017 Issued in TX

Legal business name

OLIVE DENTAL PLLC

Practice address

9510 Beechnut St
Suite A1
Houston, TX 77036-6608

Phone

(713) 382-8654

NPI assigned

Jan 28, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Thaer Al Azzawi, D.M.D.

Title

General Dentist/Owner

Phone

(713) 382-8654

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1453939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453939200000",
    "number": "1114384674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2119 WESTHEIMER RD",
            "address_2": "APT 1126",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770981974",
            "telephone_number": "713-382-8654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9510 BEECHNUT ST",
            "address_2": "SUITE A1",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770366608",
            "telephone_number": "713-382-8654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLIVE DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-28",
        "last_updated": "2016-01-28",
        "status": "A",
        "authorized_official_last_name": "AL AZZAWI",
        "authorized_official_first_name": "THAER",
        "authorized_official_title_or_position": "GENERAL DENTIST/OWNER",
        "authorized_official_telephone_number": "713-382-8654",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "31017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olive Branch Health Serv Inc
• Olive Branch Healthcare Inc.
• Olive Branch Psychological Services PLLC
• Olive Dental Group PC
• Olive Dental Group PLLC
• Olive Home Health Care
• Olive Touch Care LLC
• Anthony Olive, MD
• Kathryn Olive, PA-C
• Tyler Oliveira, PT, DPT

• Dentist in Houston, TX
• Providers in Houston, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.