Active NPI
Garrett Andrew Bethke, D.D.S.
- General Practice Dentistry
- Katy, TX
National Provider Identifier
1245306463
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 22291
- Practice address
- 21715 Kingsland Blvd
Suite 105
Katy, TX 77450-2543 - Phone
- (281) 492-6064
- Fax
- (281) 579-1808
- NPI assigned
- Nov 28, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 22291 | TX | Primary |
Addresses
Primary practice location
21715 Kingsland Blvd
Suite 105
Katy, TX 77450-2543
Mailing address
7011 Morning Sky
Katy, TX 77494-0155
Phone (281) 693-0833
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22291 | TX | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164672000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1245306463",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7011 MORNING SKY",
"city": "KATY",
"state": "TX",
"postal_code": "774940155",
"telephone_number": "281-693-0833"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21715 KINGSLAND BLVD",
"address_2": "SUITE 105",
"city": "KATY",
"state": "TX",
"postal_code": "774502543",
"telephone_number": "281-492-6064",
"fax_number": "281-579-1808"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BETHKE",
"first_name": "GARRETT",
"middle_name": "ANDREW",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "22291",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Katy, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.