KTJP Huntsville Dental PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

KTJP HUNTSVILLE DENTAL PLLC

Practice address

1333 Windsor St
Huntsville, TX 77340-5615

Phone

(936) 291-9021

NPI assigned

Jan 29, 2020

Organization subpart

No

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

Authorized official

Name

Suzanne Le

Title

Office Manager

Phone

(832) 878-3353

Specialties & licenses 2

Addresses

Other names 1

• Huntsville Dental Clinic Doing business as

Locations

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

{
    "created_epoch": "1580256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595548800000",
    "number": "1215568274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1333 WINDSOR ST",
            "city": "HUNTSVILLE",
            "state": "TX",
            "postal_code": "773405615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1333 WINDSOR ST",
            "city": "HUNTSVILLE",
            "state": "TX",
            "postal_code": "773405615",
            "telephone_number": "936-291-9021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KTJP HUNTSVILLE DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-29",
        "last_updated": "2020-07-24",
        "certification_date": "2020-07-24",
        "status": "A",
        "authorized_official_last_name": "LE",
        "authorized_official_first_name": "SUZANNE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "832-878-3353"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Huntsville Dental Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Huntsville Dental Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Paul Gregory Kooi, D.D.S.
• Angela M Koranek, PHARM.D.
• Jason Koranek, DDS
• Stefanie Krejci
• Kroger Texas L P
• Nikita L'Shay Lagway
• Eid Lahoud
• John V Lai
• Lakewood Arthritis and Osteoporosis Clinic PLLC
• Lakewood Dental Associates, PLLC

• Dental Clinic/Center in Huntsville, TX
• Providers in Huntsville, TX by specialty
• Dental Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 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.