Organization
DENTAL INNOVATIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESUS MARIO VELASQUEZ (D.D.S.,MS.)
(713) 785-3355
Entity
Organization
Contact information
Practice address
900 BROADWAY ST, HOUSTON, TX 77012-2127
(713) 928-3311
(713) 928-9253
Mailing address
900 BROADWAY ST, HOUSTON, TX 77012-2127
(713) 928-3311
(713) 928-9253
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
18000
TX
1223P0300X
Periodontics
18000
TX
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
18000
TX
Other
Enumeration date
05/17/2007
Last updated
09/11/2025
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