Southern Dental at Pasadena PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

SOUTHERN DENTAL AT PASADENA PLLC

Practice address

7219 Fairmont Pkwy Ste 100
Pasadena, TX 77505-4612

Phone

(678) 756-5921

NPI assigned

Nov 12, 2015

Organization subpart

No

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

Authorized official

Name

Steve Wingfield, DDS

Title

Coo

Phone

(678) 756-5921

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1447286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447286400000",
    "number": "1134592199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7219 FAIRMONT PKWY STE 100",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775054612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7219 FAIRMONT PKWY STE 100",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775054612",
            "telephone_number": "678-756-5921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN DENTAL AT PASADENA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-12",
        "last_updated": "2015-11-12",
        "status": "A",
        "authorized_official_last_name": "WINGFIELD",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "678-756-5921",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2015; 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.