NPIMap

Organization Active NPI

Luminous Dental

  • Dentist
  • Spring, TX
National Provider Identifier
1245628304
Registry record updated Dec 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
24223 Issued in TX
Legal business name
LUMINOUS DENTAL
Practice address
566 Sawdust Rd
Spring, TX 77380-2245
Phone
(281) 948-1612
NPI assigned
Dec 23, 2014
Last updated
Dec 23, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2014

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

Authorized official

Name
Juan Carlos Fernandez, DDS, MS
Title
Owner
Phone
(281) 948-1612

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 24223 TX Primary

Addresses

Primary practice location

566 Sawdust Rd
Spring, TX 77380-2245

Mailing address

566 Sawdust Rd
Spring, TX 77380-2245
Phone (281) 948-1612

National Provider Directory

National Provider Directory

Locations

566 Sawdust Rd
Spring, TX 77380
Phone (281) 292-4400

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1419292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419292800000",
    "number": "1245628304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "566 SAWDUST RD",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773802245",
            "telephone_number": "281-948-1612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "566 SAWDUST RD",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773802245",
            "telephone_number": "281-948-1612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUMINOUS DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-23",
        "last_updated": "2014-12-23",
        "status": "A",
        "authorized_official_last_name": "FERNANDEZ",
        "authorized_official_first_name": "JUAN CARLOS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "281-948-1612",
        "authorized_official_credential": "DDS, MS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "24223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 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.