Ut Dental Branch

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

22145 Issued in TX

Legal business name

UT DENTAL BRANCH

Practice address

4106 Lehigh Ave
Houston, TX 77005-1933

Phone

(713) 349-9521

NPI assigned

Sep 12, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Robin Weltman

Title

Director

Phone

(713) 486-4056

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1347408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347408000000",
    "number": "1093065583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4106 LEHIGH AVE",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770051933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4106 LEHIGH AVE",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770051933",
            "telephone_number": "713-349-9521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UT DENTAL BRANCH",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-12",
        "last_updated": "2012-09-12",
        "status": "A",
        "authorized_official_last_name": "WELTMAN",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "713-486-4056",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "TX",
            "license": "22145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Periodontics in Houston, TX
• Providers in Houston, TX by specialty
• Periodontics in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2012; 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.