Southern Dental Specialists PLLC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

20273 Issued in TX

Legal business name

SOUTHERN DENTAL SPECIALISTS PLLC

Practice address

310 W 19TH St
Houston, TX 77008-3906

Phone

(713) 861-6250

Fax

(713) 869-6414

NPI assigned

Oct 12, 2015

Organization subpart

No

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

Authorized official

Name

Arnold Pope

Title

Credentialing

Phone

(713) 861-6250

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1444608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582675200000",
    "number": "1033580493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8000 W INTERSTATE 10 STE 407",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782303871",
            "telephone_number": "210-774-4588",
            "fax_number": "210-640-5995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 W 19TH ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770083906",
            "telephone_number": "713-861-6250",
            "fax_number": "713-869-6414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN DENTAL SPECIALISTS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-12",
        "last_updated": "2020-02-26",
        "certification_date": "2020-02-26",
        "status": "A",
        "authorized_official_last_name": "POPE",
        "authorized_official_first_name": "ARNOLD",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "713-861-6250"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "TX",
            "license": "20273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https:southerndental.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "310 W 19th St",
            "city": "Houston",
            "state": "TX",
            "country_code": "US",
            "postal_code": "770083906",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Southern Dental at Spring Branch PLLC
• Southern Dental at Willowbrook PLLC
• Southern Family Pharmacy Inc
• Southern Healthcare Services Inc
• Southern Healthcare Services LLC
• Southern Hospice and Palliative Care Inc
• Southern Medic Durable Equipment

• Orthodontics and Dentofacial Orthopedics Dentistry in Houston, TX
• Providers in Houston, TX by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2020; 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.