# DEEP SEA DENTAL PLLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912462136
- **Authorized official:** SHAHROUZ AKHAVAN (MEMBER)
- **Authorized official phone:** (956) 380-2482

## Contact information

- **Practice address:** 603 SOUTH EXPRESSWAY 83, SUITE H2, HARLINGEN, TX 78550
- **Practice address phone:** (956) 380-2482
- **Mailing address:** 307 E UNIVERSITY DR, EDINBURG, TX 78539-3549

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 02/01/2019
- **Last updated:** 07/15/2024