Julie Wathen Long, DDS PA

Primary specialty

DentistTaxonomy code 122300000X

License

18753 Issued in TX

Practice address

1575 West Grand Parkway
#1200
Katy, TX 77494

Phone

(281) 395-1700

Fax

(281) 395-1725

NPI assigned

Sep 13, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Apr 8, 2016 through Apr 8, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Dentists at Grand Parkway

  • General Practice Dentistry
  • Katy, TX
  • NPI 1689779928
  NPD (past) Authorized official
• The Dentists at Grand Parkway, PLLC

  • General Practice Dentistry
  • Katy, TX
  • NPI 1710530449
  NPD (past)

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295830537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1575 WEST GRAND PARKWAY",
            "address_2": "#1200",
            "city": "KATY",
            "state": "TX",
            "postal_code": "77494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1575 WEST GRAND PARKWAY",
            "address_2": "#1200",
            "city": "KATY",
            "state": "TX",
            "postal_code": "77494",
            "telephone_number": "281-395-1700",
            "fax_number": "281-395-1725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "JULIE",
        "middle_name": "WATHEN",
        "name_prefix": "Dr.",
        "credential": "DDS PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "18753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lone Star Pathology PLLC
• Loneya Care
• Amy L Long, LPC-ASSOCIATE
• Emily Grace Long, PT
• James O Long, DDS
• Kelly Denise Long
• Lindsay Anne Long, LMFT
• Staci Scroggin Long, M.S., CCC-SLP
• Eyitayo Longe
• Angela Lynn Longoria, LMFT-A

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

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.