NPIMap

Organization Active NPI

Northland Family Dental

  • Dentist
  • Tomball, TX
National Provider Identifier
1043513732
Registry record updated Dec 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
19059 Issued in TX
Legal business name
NORTHLAND FAMILY DENTAL
Practice address
24179 Tomball Pkwy
Suite B
Tomball, TX 77375-8298
Phone
(281) 377-6788
Fax
(281) 971-3948
NPI assigned
Dec 17, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2010

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

Authorized official

Name
Dr. Bryant Deon Conley, DDS
Title
Dentist/Owner
Phone
(281) 377-6788

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 19059 TX Primary

Addresses

Primary practice location

24179 Tomball Pkwy
Suite B
Tomball, TX 77375-8298

Mailing address

24179 Tomball Pkwy
Suite B
Tomball, TX 77375-8298
Phone (281) 377-6788

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1292544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292544000000",
    "number": "1043513732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24179 TOMBALL PKWY",
            "address_2": "SUITE B",
            "city": "TOMBALL",
            "state": "TX",
            "postal_code": "773758298",
            "telephone_number": "281-377-6788",
            "fax_number": "281-971-3948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24179 TOMBALL PKWY",
            "address_2": "SUITE B",
            "city": "TOMBALL",
            "state": "TX",
            "postal_code": "773758298",
            "telephone_number": "281-377-6788",
            "fax_number": "281-971-3948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHLAND FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-17",
        "last_updated": "2010-12-17",
        "status": "A",
        "authorized_official_last_name": "CONLEY",
        "authorized_official_first_name": "BRYANT",
        "authorized_official_middle_name": "DEON",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "281-377-6788",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "19059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Dec 17, 2010; 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.