Liquid Dental, PLLC

Primary specialty

DentistTaxonomy code 122300000X

License

25304 Issued in TX

Legal business name

LIQUID DENTAL, PLLC

Doing business as

Agua Dental

Practice address

105 South Cesar Chavez Road
Suite #2
San Juan, TX 78589

Phone

(956) 380-2482

NPI assigned

Oct 28, 2013

Organization subpart

No

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

Authorized official

Name

Shahrouz Akhavan, D.D.S.

Title

Owner

Phone

(956) 380-2482

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Agua Dental Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Henry Tran, DDS

  • Dentist
  • Edinburg, TX
  • NPI 1902525827
  NPD (past)

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

{
    "created_epoch": "1382918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1382918400000",
    "number": "1811325970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 E UNIVERSITY DR",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785393549",
            "telephone_number": "956-380-2482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 SOUTH CESAR CHAVEZ ROAD",
            "address_2": "SUITE #2",
            "city": "SAN JUAN",
            "state": "TX",
            "postal_code": "78589",
            "telephone_number": "956-380-2482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIQUID DENTAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-28",
        "last_updated": "2013-10-28",
        "status": "A",
        "authorized_official_last_name": "AKHAVAN",
        "authorized_official_first_name": "SHAHROUZ",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "956-380-2482",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "25304",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "211344106",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Agua Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kenia Victoria Lee, PNP
• Legacy Smiles of San Juan PLLC
• Life Skills Therapy Center
• Lifechek Dennison LLC
• Line Care Health Services, LLC.
• Little Manhattan Pediatric Dentistry,PLLC
• Gregoria Lopez, LBSW
• Yolanda T. Lopez, LMSW
• Los Encinos Adult Day Care Center, Inc.
• Luanna Roxanne Lozano

• Dentist in San Juan, TX
• Providers in San Juan, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2013; 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.