Active NPI
Memorial Dental Associates PLLC
- Pediatric Dentistry
- Houston, TX
National Provider Identifier
1043857931
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- Legal business name
- MEMORIAL DENTAL ASSOCIATES PLLC
- Practice address
- 11451 Katy Fwy Ste 105
Houston, TX 77079-2008 - Phone
- (713) 465-8239
- NPI assigned
- Dec 10, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Neha Joshi
- Title
- Credentialing Specialist
- Phone
- (281) 899-0094
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | |||
| Pediatric Dentistry | 1223P0221X | Primary |
Addresses
Primary practice location
11451 Katy Fwy Ste 105
Houston, TX 77079-2008
Mailing address
11451 Katy Fwy Ste 105
Houston, TX 77079-2008
National Provider Directory
National Provider DirectoryLocations
11451 Katy Fwy
Ste 105
Houston, TX 77079
Phone (713) 465-8239
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": "1575936000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1576108800000",
"number": "1043857931",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11451 KATY FWY STE 105",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770792008"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11451 KATY FWY STE 105",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770792008",
"telephone_number": "713-465-8239"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MEMORIAL DENTAL ASSOCIATES PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2019-12-10",
"last_updated": "2019-12-12",
"certification_date": "2019-12-12",
"status": "A",
"authorized_official_last_name": "JOSHI",
"authorized_official_first_name": "NEHA",
"authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
"authorized_official_telephone_number": "281-899-0094",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": null,
"license": null,
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, Pediatric Dentistry",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
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 Dec 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.