NPIMap

Organization Active NPI

Centra Two Dental

  • General Practice Dentistry
  • Pearland, TX
National Provider Identifier
1174787378
Registry record updated Jul 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
19860 Issued in TX
Legal business name
CENTRA TWO DENTAL
Practice address
5103 Broadway St
109
Pearland, TX 77581-3900
Phone
(281) 485-7767
Fax
(281) 485-7745
NPI assigned
Jul 16, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2008

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

Authorized official

Name
Hiep Duy Pham, DDSNPI 1144330499
Title
Owner
Phone
(281) 485-7767

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 19860 TX Primary

Addresses

Primary practice location

5103 Broadway St
109
Pearland, TX 77581-3900

Mailing address

5103 Broadway St
109
Pearland, TX 77581-3900
Phone (281) 485-7767

National Provider Directory

National Provider Directory

Locations

5103 Broadway St
Ste 109
Pearland, TX 77581
Phone (281) 485-7767

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1216166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216166400000",
    "number": "1174787378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5103 BROADWAY ST",
            "address_2": "109",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775813900",
            "telephone_number": "281-485-7767",
            "fax_number": "281-485-7745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5103 BROADWAY ST",
            "address_2": "109",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775813900",
            "telephone_number": "281-485-7767",
            "fax_number": "281-485-7745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRA TWO DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-16",
        "last_updated": "2008-07-16",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "HIEP",
        "authorized_official_middle_name": "DUY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "281-485-7767",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "19860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pearland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2008; 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.