Active NPI
Lorraine Bautista-Ngo, DDS
- Dentist
- Tomball, TX
National Provider Identifier
1134500317
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 30958
- Practice address
- 24179 State Highway 249 Ste B
Tomball, TX 77375-8299 - Phone
- (281) 357-9460
- NPI assigned
- Jun 14, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 30958 | TX | Primary |
Addresses
Primary practice location
24179 State Highway 249 Ste B
Tomball, TX 77375-8299
Mailing address
14322 Ardwell Dr
Sugar Land, TX 77498-5106
Phone (832) 877-7201
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30958 | TX | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1434240000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1653004800000",
"number": "1134500317",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14322 ARDWELL DR",
"city": "SUGAR LAND",
"state": "TX",
"postal_code": "774985106",
"telephone_number": "832-877-7201"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24179 STATE HIGHWAY 249 STE B",
"city": "TOMBALL",
"state": "TX",
"postal_code": "773758299",
"telephone_number": "281-357-9460"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAUTISTA-NGO",
"first_name": "LORRAINE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-06-14",
"last_updated": "2022-05-20",
"certification_date": "2022-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "30958",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tomball, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 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.