Mai Vantage Dental PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

28160 Issued in TX

Legal business name

MAI VANTAGE DENTAL PLLC

Practice address

28527 Tomball Pkwy
Tomball, TX 77375-4545

Phone

(832) 613-7743

Fax

(281) 907-8003

NPI assigned

Jul 27, 2017

Organization subpart

No

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

Authorized official

Name

Jennifer Mai, DDSNPI 1669737219

Title

Owner

Phone

(832) 613-7743

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Restoration Smiles Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jennifer Mai, D.D.S.

  • General Practice Dentistry
  • Tomball, TX
  • NPI 1669737219
  Medicare reassignment NPD Authorized official
• Eric S Moon, D.D.S.

  • General Practice Dentistry
  • Tomball, TX
  • NPI 1366841439
  NPD
• Reagan Reynolds

  • Specialist
  • Pinehurst, TX
  • NPI 1720776461
  NPD (past)

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

{
    "created_epoch": "1501113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707264000000",
    "number": "1053835488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28527 TOMBALL PKWY",
            "city": "TOMBALL",
            "state": "TX",
            "postal_code": "773754545",
            "telephone_number": "713-623-1122",
            "fax_number": "281-907-8003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28527 TOMBALL PKWY",
            "city": "TOMBALL",
            "state": "TX",
            "postal_code": "773754545",
            "telephone_number": "832-613-7743",
            "fax_number": "281-907-8003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAI VANTAGE DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-27",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A",
        "authorized_official_last_name": "MAI",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "832-613-7743",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "28160",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3093486-13",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3728164-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Restoration Smiles",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Restoration Smiles",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Karen Carter Lyon, PHD RN CNS
• M O D & Associates Inc
• M. Atif Rahi, M.D., PA
• Anh Ngoc Ma, FNP
• Kathy Macnak, MSN, FNP
• Jennifer Mai, D.D.S.
• Majestic Dental PLLC
• Alecia Walker Mallett, RN, NP-C
• Mamai Home Healthcare Corporation
• Man Tooth Oral Services PLLC

• General Practice Dentistry in Tomball, TX
• Providers in Tomball, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.