Conglomerate PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

CONGLOMERATE PLLC

Practice address

1620 Grand Avenue Pkwy Ste 130
Pflugerville, TX 78660-2185

Phone

(512) 670-8482

NPI assigned

Mar 2, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Laresea Woods, DDS

Title

Dentist/Part-Owner

Phone

(334) 590-4223

Specialties & licenses 1

Addresses

Other names 1

• The Grand Family Dental Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Charles Norman Alston III, D.D.S.

  • General Practice Dentistry
  • Pflugerville, TX
  • NPI 1386950624
  NPD

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

{
    "created_epoch": "1583107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586390400000",
    "number": "1154955805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 GRAND AVENUE PKWY STE 130",
            "city": "PFLUGERVILLE",
            "state": "TX",
            "postal_code": "786602185",
            "telephone_number": "512-670-8482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 GRAND AVENUE PKWY STE 130",
            "city": "PFLUGERVILLE",
            "state": "TX",
            "postal_code": "786602185",
            "telephone_number": "512-670-8482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONGLOMERATE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-02",
        "last_updated": "2020-04-09",
        "certification_date": "2020-04-09",
        "status": "A",
        "authorized_official_last_name": "WOODS",
        "authorized_official_first_name": "LARESEA",
        "authorized_official_title_or_position": "DENTIST/PART-OWNER",
        "authorized_official_telephone_number": "334-590-4223",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Grand Family Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Grand Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dentist in Pflugerville, TX
• Providers in Pflugerville, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2020; 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.