NPIMap

Organization Active NPI

College Station Modern Dentistry PC

  • Dentist
  • College Station, TX
National Provider Identifier
1124420781
Registry record updated Jun 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
COLLEGE STATION MODERN DENTISTRY PC
Practice address
915 William D. Fitch Parkway
Suite 300
College Station, TX 77845
Phone
(979) 690-7201
NPI assigned
Sep 25, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2022

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

Authorized official

Name
Dr. Vera Pinkstaff, DDS
Title
Owner/Doctor
Phone
(714) 845-8703

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

915 William D. Fitch Parkway
Suite 300
College Station, TX 77845

Mailing address

PO Box 920050
Dallas, TX 75392-0050
Phone (714) 845-8703

Other names 1

  • College Station Modern Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

915 William D Fitch Pkwy
#300
College Station, TX 77845
Phone (440) 525-0847

Practitioners & affiliated clinicians

Practitioners 6

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": "1411603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655164800000",
    "number": "1124420781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 920050",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753920050",
            "telephone_number": "714-845-8703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 WILLIAM D. FITCH PARKWAY",
            "address_2": "SUITE 300",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "77845",
            "telephone_number": "979-690-7201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLEGE STATION MODERN DENTISTRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-25",
        "last_updated": "2022-06-14",
        "certification_date": "2022-06-14",
        "status": "A",
        "authorized_official_last_name": "PINKSTAFF",
        "authorized_official_first_name": "VERA",
        "authorized_official_title_or_position": "OWNER/DOCTOR",
        "authorized_official_telephone_number": "714-845-8703",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "College Station Modern Dentistry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "College Station Modern Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in College Station, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2022; 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.