St. Jude Dental P.C

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

22568 Issued in TX

Legal business name

ST. JUDE DENTAL P.C

Practice address

8420 S Sam Houston Pkwy W Ste 260
Houston, TX 77085-2283

Phone

(972) 224-5397

Fax

(972) 224-0344

NPI assigned

Apr 14, 2010

Organization subpart

No

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

Authorized official

Name

Emeka Jude Abazie, DDS

Title

Dentist

Phone

(972) 224-5397

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1271203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271203200000",
    "number": "1053637199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 N BECKLEY AVE #420C",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "75115",
            "telephone_number": "972-224-5397",
            "fax_number": "972-224-0344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8420 S SAM HOUSTON PKWY W STE 260",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770852283",
            "telephone_number": "972-224-5397",
            "fax_number": "972-224-0344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JUDE DENTAL P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-14",
        "last_updated": "2010-04-14",
        "status": "A",
        "authorized_official_last_name": "ABAZIE",
        "authorized_official_first_name": "EMEKA",
        "authorized_official_middle_name": "JUDE",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "972-224-5397",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "TX",
            "license": "22568",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1578657763",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dental Clinic/Center in Houston, TX
• Providers in Houston, TX by specialty
• Dental Clinic/Center in Texas

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