NPIMap

Organization Active NPI

Conroe Dental PC

Doing business as Conroe Dental

  • Dentist
  • Conroe, TX
National Provider Identifier
1275917999
Registry record updated Jul 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
21886 Issued in TX
Legal business name
CONROE DENTAL PC
Doing business as
Conroe Dental
Practice address
1002 N Loop 336 W
Conroe, TX 77301-1154
Phone
(936) 760-3050
Fax
(936) 441-3068
NPI assigned
Jul 13, 2015
Last updated
Jul 13, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2015

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

Authorized official

Name
Dr. Kenneth Osamor, DDSNPI 1942427943
Title
Director
Phone
(936) 760-3050

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
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 21886 TX Primary

Addresses

Primary practice location

1002 N Loop 336 W
Conroe, TX 77301-1154

Mailing address

1002 N Loop 336 W
Conroe, TX 77301-1154
Phone (936) 760-3050

Other names 1

  • CONROE DENTAL Doing business as

National Provider Directory

National Provider Directory

Locations

1002 N Loop 336 W
Conroe, TX 77301
Phone (936) 760-3050

Practitioners & affiliated clinicians

Practitioners 5

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": "1436745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436745600000",
    "number": "1275917999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 N LOOP 336 W",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773011154",
            "telephone_number": "936-760-3050",
            "fax_number": "936-441-3068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 N LOOP 336 W",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773011154",
            "telephone_number": "936-760-3050",
            "fax_number": "936-441-3068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONROE DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-13",
        "last_updated": "2015-07-13",
        "status": "A",
        "authorized_official_last_name": "OSAMOR",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "936-760-3050",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "21886",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CONROE DENTAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Conroe, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2015; 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.