Fossum Family Dental Care

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

22804 Issued in TX

Legal business name

FOSSUM FAMILY DENTAL CARE

Practice address

1840 FM 359
Richmond, TX 77406

Phone

(832) 595-2266

Fax

(832) 595-2293

NPI assigned

Apr 24, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Steve Fossum, DDS

Title

Dentist/Owner

Phone

(832) 595-2266

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1240531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631232000000",
    "number": "1003050717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1840 FM 359",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "77406",
            "telephone_number": "832-595-2266",
            "fax_number": "832-595-2293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1840 FM 359",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "77406",
            "telephone_number": "832-595-2266",
            "fax_number": "832-595-2293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOSSUM FAMILY DENTAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-24",
        "last_updated": "2021-09-10",
        "certification_date": "2021-09-10",
        "status": "A",
        "authorized_official_last_name": "FOSSUM",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "832-595-2266",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "22804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2021; 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.