Odessa Dental Solution PA

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

17794 Issued in TX

Legal business name

ODESSA DENTAL SOLUTION PA

Practice address

2470 E 11TH St
Odessa, TX 79762

Phone

(432) 333-4500

Fax

(432) 333-4505

NPI assigned

Sep 19, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Shihab M Diais, DDSNPI 1205091113

Title

Ceo Dentist

Phone

(432) 333-4500

Specialties & licenses 1

Addresses

Other names 1

• Shihab M Diais DBA Dental Solution Former legal business name

Locations

Practitioners 1

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

• Shihab M Diais, D.D.S

  • General Practice Dentistry
  • Odessa, TX
  • NPI 1205091113
  NPD (past) Authorized official

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

{
    "created_epoch": "1158624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1962509570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2470 E 11TH ST",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "79762",
            "telephone_number": "432-333-4500",
            "fax_number": "432-333-4505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2470 E 11TH ST",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "79762",
            "telephone_number": "432-333-4500",
            "fax_number": "432-333-4505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ODESSA DENTAL SOLUTION PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DIAIS",
        "authorized_official_first_name": "SHIHAB",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO DENTIST",
        "authorized_official_telephone_number": "432-333-4500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "TX",
            "license": "17794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shihab M Diais DBA Dental Solution",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Endodontics in Odessa, TX
• Providers in Odessa, TX by specialty
• Endodontics in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.