Portrait Dental PLLC

Primary specialty

DentistTaxonomy code 122300000X

License

24171 Issued in TX

Legal business name

PORTRAIT DENTAL PLLC

Practice address

27131 Cinco Ranch Blvd
Suite #250
Katy, TX 77494

Phone

(832) 483-4583

NPI assigned

Sep 14, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Minh Duc Nguyen, DDS

Title

Member

Phone

(832) 483-4583

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1442188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442188800000",
    "number": "1023486503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27131 CINCO RANCH BLVD",
            "address_2": "SUITE #250",
            "city": "KATY",
            "state": "TX",
            "postal_code": "77494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27131 CINCO RANCH BLVD",
            "address_2": "SUITE #250",
            "city": "KATY",
            "state": "TX",
            "postal_code": "77494",
            "telephone_number": "832-483-4583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTRAIT DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-14",
        "last_updated": "2015-09-14",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "MINH",
        "authorized_official_middle_name": "DUC",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "832-483-4583",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "24171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Katy, TX
• Providers in Katy, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 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.