NPIMap

Organization Active NPI

Dental Health Associates of Texas, PC

  • General Practice Dentistry
  • Pearland, TX
National Provider Identifier
1053777490
Registry record updated Mar 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DENTAL HEALTH ASSOCIATES OF TEXAS, PC
Practice address
12567 Broadway St.
Suite 129
Pearland, TX 77584
Phone
(832) 672-8648
Fax
(832) 672-6869
NPI assigned
Jan 14, 2016
Organization subpart
Yes
Parent organization
DENTAL HEALTH ASSOCIATES OF TEXAS, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 25, 2016

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

Authorized official

Name
Kendra Walker
Title
Credentialing Team Lead
Phone
(217) 540-8312

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

12567 Broadway St.
Suite 129
Pearland, TX 77584

Mailing address

12567 Broadway St.
Suite 129
Pearland, TX 77584

Other names 1

  • Kingsley Family Dental Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dental Health Associates of TX PC148 organizations share this tax ID, including this one
Part of
Dental Health Associates of TX PC

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

12567 Broadway St
Ste 129
Pearland, TX 77584
Phone (832) 672-8648

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": "1452729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458864000000",
    "number": "1053777490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12567 BROADWAY ST.",
            "address_2": "SUITE 129",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "77584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12567 BROADWAY ST.",
            "address_2": "SUITE 129",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "77584",
            "telephone_number": "832-672-8648",
            "fax_number": "832-672-6869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL HEALTH ASSOCIATES OF TEXAS, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENTAL HEALTH ASSOCIATES OF TEXAS, PC",
        "enumeration_date": "2016-01-14",
        "last_updated": "2016-03-25",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "KENDRA",
        "authorized_official_title_or_position": "CREDENTIALING TEAM LEAD",
        "authorized_official_telephone_number": "217-540-8312"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kingsley Family Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pearland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2016; 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.