NPIMap

Organization Active NPI

Wallisville Dental Associates, PA

  • General Practice Dentistry
  • Houston, TX
National Provider Identifier
1083816458
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
21151 Issued in TX
Legal business name
WALLISVILLE DENTAL ASSOCIATES, PA
Practice address
14570 Wallisville Road
Suite 2
Houston, TX 77049
Phone
(713) 453-2500
Fax
(713) 453-2501
NPI assigned
Jun 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Phuong T Nguyen, D.D.S.NPI 1144376823
Title
Dentist
Phone
(713) 453-2500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 21151 TX Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 22767 TX

Addresses

Primary practice location

14570 Wallisville Road
Suite 2
Houston, TX 77049

Mailing address

14570 Wallisville Road
Suite 2
Houston, TX 77049
Phone (713) 453-2500

National Provider Directory

National Provider Directory

Locations

14570 Wallisville Rd
Ste 2
Houston, TX 77049
Phone (713) 453-2500

Practitioners & affiliated clinicians

Practitioners 10

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": "1181001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1083816458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14570 WALLISVILLE ROAD",
            "address_2": "SUITE 2",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77049",
            "telephone_number": "713-453-2500",
            "fax_number": "713-453-2501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14570 WALLISVILLE ROAD",
            "address_2": "SUITE 2",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77049",
            "telephone_number": "713-453-2500",
            "fax_number": "713-453-2501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALLISVILLE DENTAL ASSOCIATES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "PHUONG",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "713-453-2500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "21151",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "22767",
            "primary": false
        }
    ],
    "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 Aug 22, 2020; 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.