NPIMap

Organization Active NPI

Waller Dental Associates PA

  • General Practice Dentistry
  • Waller, TX
National Provider Identifier
1104129279
Registry record updated Dec 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
21047 Issued in TX
Legal business name
WALLER DENTAL ASSOCIATES PA
Practice address
31315 FM 2920 Rd
Suite 16a
Waller, TX 77484-8049
Phone
(281) 781-6009
Fax
(713) 674-0811
NPI assigned
Dec 13, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2010

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

Authorized official

Name
Dr. Amjad A Sheikh, DDS
Title
President
Phone
(281) 781-6009

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 21047 TX Primary

Addresses

Primary practice location

31315 FM 2920 Rd
Suite 16a
Waller, TX 77484-8049

Mailing address

31315 FM 2920 Rd
Suite 16a
Waller, TX 77484-8049
Phone (281) 781-6009

National Provider Directory

National Provider Directory

Locations

31315 FM 2920 Rd
Ste 16A
Waller, TX 77484
Phone (936) 372-2673

NPI Registry JSON

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

{
    "created_epoch": "1292198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292198400000",
    "number": "1104129279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31315 FM 2920 RD",
            "address_2": "SUITE 16A",
            "city": "WALLER",
            "state": "TX",
            "postal_code": "774848049",
            "telephone_number": "281-781-6009",
            "fax_number": "713-674-0811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31315 FM 2920 RD",
            "address_2": "SUITE 16A",
            "city": "WALLER",
            "state": "TX",
            "postal_code": "774848049",
            "telephone_number": "281-781-6009",
            "fax_number": "713-674-0811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALLER DENTAL ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-13",
        "last_updated": "2010-12-13",
        "status": "A",
        "authorized_official_last_name": "SHEIKH",
        "authorized_official_first_name": "AMJAD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "281-781-6009",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "21047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waller, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2010; 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.