Houston Children'S Dental Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

HOUSTON CHILDREN'S DENTAL CENTER, LLC

Practice address

3800 N Shepherd Dr Ste B
Houston, TX 77018-6411

Phone

(713) 814-4717

Fax

(713) 568-1633

NPI assigned

Nov 24, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Devin Larsen

Title

Ceo

Phone

(717) 759-4375

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Ambulatory surgical center certification: CCN 45C0001518

Legal name

HOUSTON CHILDREN'S DENTAL CENTER, LLC

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Jun 22, 2011

Last certification

Jun 14, 2018

Ownership / control type

Proprietary

Facility address

3800 N Shepherd Dr, Ste B
Houston, TX 77018

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1290556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737936000000",
    "number": "1134421175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9709 LAKESIDE BLVD STE 350",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773811213",
            "telephone_number": "713-489-2198",
            "fax_number": "713-489-2978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 N SHEPHERD DR STE B",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770186411",
            "telephone_number": "713-814-4717",
            "fax_number": "713-568-1633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOUSTON CHILDREN'S DENTAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-24",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A",
        "authorized_official_last_name": "LARSEN",
        "authorized_official_first_name": "DEVIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "717-759-4375",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ambulatory Surgical Clinic/Center in Houston, TX
• Providers in Houston, TX by specialty
• Ambulatory Surgical Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.