DEEP SEA DENTAL PLLC NPI 1912462136

NPI Information

  • NPI: 1912462136
  • Provider Name: DEEP SEA DENTAL PLLC
  • Classification: Dentist - 1223S0112X
  • Specialization: Oral and Maxillofacial Surgery
  • Entity Type: Organization
  • Address: 603 SOUTH EXPRESSWAY 83
    SUITE H2
    HARLINGEN, TX
    ZIP 78550
  • Phone: (956) 380-2482

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NPI Details

DEEP SEA DENTAL PLLC is an oral and maxillofacial surgery dentist in Harlingen, TX. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. DEEP SEA DENTAL PLLC NPI is 1912462136. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

603 SOUTH EXPRESSWAY 83
SUITE H2
HARLINGEN, TX
ZIP 78550
Phone: (956) 380-2482

The provider's authorized official is Shahrouz Akhavan .
The authorized official title is Member and has the following contact phone number (956) 380-2482.

The enumeration date for this NPI number is 2/1/2019 and was last updated on 7/15/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223S0112XDentistOral and Maxillofacial SurgeryYes

What is NPI?

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This page was last updated on: 11/21/2025

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