South Loop Dental Services, PLLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

SOUTH LOOP DENTAL SERVICES, PLLC

Practice address

3577 Yellowstone Blvd
Houston, TX 77021-2440

Phone

(713) 398-5329

NPI assigned

Apr 24, 2025

Organization subpart

No

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

Authorized official

Name

Tara Nicole Johnson, DDSNPI 1851685697

Title

Owner

Phone

(713) 398-5329

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Tara Nicole Johnson, DDS

  • Pediatric Dentistry
  • Humble, TX
  • NPI 1851685697
  NPD Authorized official

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

{
    "created_epoch": "1745452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1083401616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8144",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772888144",
            "telephone_number": "713-398-5329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3577 YELLOWSTONE BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770212440",
            "telephone_number": "713-398-5329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH LOOP DENTAL SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-24",
        "last_updated": "2025-09-11",
        "certification_date": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "TARA",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "713-398-5329",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1851685697",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• South Houston Mint Dentistry, PLLC
• South Houston Momentum PLLC
• South Lake Houston Emergency Medical Services
• South Limestone Hospital District
• South Limestone Hospital District
• South Loop Dentistry, P.C.
• South Loop MRI LP
• South Main Clinic Inc
• South Main Clinic, Inc
• South Main Medical Clinic

• Pediatric Dentistry in Houston, TX
• Providers in Houston, TX by specialty
• Pediatric Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.