NPIMap

Organization Active NPI

Freshstart Pro

  • Dentist
  • Houston, TX
National Provider Identifier
1043572555
Registry record updated Jun 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
19595 Issued in TX
Legal business name
FRESHSTART PRO
Practice address
4061 Bellaire Blvd
Suite C
Houston, TX 77025-1121
Phone
(713) 664-1337
NPI assigned
Jun 11, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2012

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

Authorized official

Name
Mazen S Ghattas, DMD,FAGD,CAGS,MSNPI 1801067293
Title
Dentist
Phone
(713) 664-1337

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 19595 TX Primary

Addresses

Primary practice location

4061 Bellaire Blvd
Suite C
Houston, TX 77025-1121

Mailing address

4061 Bellaire Blvd
Suite C
Houston, TX 77025-1121
Phone (713) 664-1337

Other names 1

  • DENTAL DESIGNERS Former legal business name

National Provider Directory

National Provider Directory

Locations

4061 Bellaire Blvd
#C
Houston, TX 77025
Phone (713) 660-0966

Practitioners & affiliated clinicians

Practitioners 1

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": "1339372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339372800000",
    "number": "1043572555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4061 BELLAIRE BLVD",
            "address_2": "SUITE C",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770251121",
            "telephone_number": "713-664-1337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4061 BELLAIRE BLVD",
            "address_2": "SUITE C",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770251121",
            "telephone_number": "713-664-1337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRESHSTART PRO",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-11",
        "last_updated": "2012-06-11",
        "status": "A",
        "authorized_official_last_name": "GHATTAS",
        "authorized_official_first_name": "MAZEN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "713-664-1337",
        "authorized_official_credential": "DMD,FAGD,CAGS,MS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "19595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DENTAL DESIGNERS",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2012; 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.