Killeen Modern Dentistry, PC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

KILLEEN MODERN DENTISTRY, PC

Doing business as

Killeen Modern Dentistry

Practice address

507 W Stan Schlueter Loop
Suite 104
Killeen, TX 76542

Phone

(254) 870-9209

Fax

(254) 870-9886

NPI assigned

Feb 22, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Andy Huang, DDS

Title

Owner Dentist

Phone

(254) 870-9209

Specialties & licenses 1

Addresses

Other names 1

• Killeen Modern Dentistry Doing business as

Locations

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

{
    "created_epoch": "1519257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655164800000",
    "number": "1275034597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 920050",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753920050",
            "telephone_number": "714-845-8500",
            "fax_number": "303-952-0892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 W STAN SCHLUETER LOOP",
            "address_2": "SUITE 104",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "76542",
            "telephone_number": "254-870-9209",
            "fax_number": "254-870-9886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KILLEEN MODERN DENTISTRY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-22",
        "last_updated": "2022-06-14",
        "certification_date": "2022-06-14",
        "status": "A",
        "authorized_official_last_name": "HUANG",
        "authorized_official_first_name": "ANDY",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "254-870-9209",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Killeen Modern Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2022; 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.