NPIMap

Organization Active NPI

Dental Specialists of Tomball, PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Tomball, TX
National Provider Identifier
1003205485
Registry record updated Jan 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
21280 Issued in TX
Legal business name
DENTAL SPECIALISTS OF TOMBALL, PLLC
Practice address
1123 Alma St
Tomball, TX 77375-4518
Phone
(281) 351-2200
NPI assigned
Jan 22, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2015

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

Authorized official

Name
Mr. Brad Bowsher
Title
General Manager
Phone
(281) 351-0005

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223E0200X 19953 TX
Oral and Maxillofacial Surgery (Dentist)Group: 193200000X MULTI-SPECIALTY GROUP 1223S0112X 21280 TX Primary

Addresses

Primary practice location

1123 Alma St
Tomball, TX 77375-4518

Mailing address

1123 Alma St
Tomball, TX 77375-4518
Phone (281) 351-2200

Other names 1

  • Dental Specialists of Tomball Other name

National Provider Directory

National Provider Directory

Locations

1123 Alma St
Tomball, TX 77375
Phone (281) 351-2200

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1421884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421884800000",
    "number": "1003205485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1123 ALMA ST",
            "city": "TOMBALL",
            "state": "TX",
            "postal_code": "773754518",
            "telephone_number": "281-351-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1123 ALMA ST",
            "city": "TOMBALL",
            "state": "TX",
            "postal_code": "773754518",
            "telephone_number": "281-351-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL SPECIALISTS OF TOMBALL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-22",
        "last_updated": "2015-01-22",
        "status": "A",
        "authorized_official_last_name": "BOWSHER",
        "authorized_official_first_name": "BRAD",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "281-351-0005",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": "TX",
            "license": "19953",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "21280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental Specialists of Tomball",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Tomball, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2015; 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.