Atlas Dental LP

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

19895 Issued in TX

Legal business name

ATLAS DENTAL LP

Practice address

1723 N Avenue K
Freeport, TX 77541-3605

Phone

(979) 233-1581

Fax

(979) 233-8355

NPI assigned

Oct 25, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Tom Quang Huynh

Title

Partner

Phone

(979) 233-1581

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1130198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304035200000",
    "number": "1114917846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14520 MEMORIAL DR",
            "address_2": "M144",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770795434",
            "telephone_number": "979-233-1581",
            "fax_number": "979-233-8355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1723 N AVENUE K",
            "city": "FREEPORT",
            "state": "TX",
            "postal_code": "775413605",
            "telephone_number": "979-233-1581",
            "fax_number": "979-233-8355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLAS DENTAL LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-25",
        "last_updated": "2011-04-29",
        "status": "A",
        "authorized_official_last_name": "HUYNH",
        "authorized_official_first_name": "TOM",
        "authorized_official_middle_name": "QUANG",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "979-233-1581",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "19895",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "162592301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2011; 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.