First Colony Mall Dental PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

27827 Issued in TX

Legal business name

FIRST COLONY MALL DENTAL PA

Practice address

16535 Southwest Fwy
570
Sugar Land, TX 77479-2321

Phone

(954) 846-7171

NPI assigned

Jul 22, 2014

Organization subpart

No

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

Authorized official

Name

Rostislav Krasnov, DDS

Title

Owner

Phone

(954) 846-7171

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1405987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405987200000",
    "number": "1154738151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16535 SOUTHWEST FWY",
            "address_2": "570",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774792321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16535 SOUTHWEST FWY",
            "address_2": "570",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774792321",
            "telephone_number": "954-846-7171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST COLONY MALL DENTAL PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-22",
        "last_updated": "2014-07-22",
        "status": "A",
        "authorized_official_last_name": "KRASNOV",
        "authorized_official_first_name": "ROSTISLAV",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-846-7171",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "27827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fine Medcure Corporation
• Yana Finkelshteyn, MD
• Jason Finks, CNIM
• Katy Finney, AGACNP-BC
• First Car Nemt Co.
• First Colony Primary Care, P.a.
• First Continental Life & Accident Insurance Company
• First Grade Healthcare
• Aaron David Fischer
• John H. Fischer II, M.D.

• General Practice Dentistry in Sugar Land, TX
• Providers in Sugar Land, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2014; 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.