NPIMap

Organization Active NPI

Fulshear Modern Dentistry,PC

  • Dentist
  • Katy, TX
National Provider Identifier
1306380183
Registry record updated Dec 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
FULSHEAR MODERN DENTISTRY,PC
Practice address
5102 FM 1463 Suite 100
Katy, TX 77494
Phone
(281) 204-2156
Fax
(281) 547-7340
NPI assigned
Dec 13, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2016

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

Authorized official

Name
Dr. John S Barnes, DDS
Title
Owner Dentist
Phone
(281) 204-2156

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

5102 FM 1463 Suite 100
Katy, TX 77494

Mailing address

17000 Red Hill Ave
Irvine, CA 92614-5626
Phone (714) 845-8701

Other names 1

  • Fulshear Modern Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

5102 FM 1463 Rd
Ste 100
Katy, TX 77494
Phone (281) 204-2156

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1481587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481587200000",
    "number": "1306380183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17000 RED HILL AVE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926145626",
            "telephone_number": "714-845-8701",
            "fax_number": "949-474-1495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5102 FM 1463 SUITE 100",
            "city": "KATY",
            "state": "TX",
            "postal_code": "77494",
            "telephone_number": "281-204-2156",
            "fax_number": "281-547-7340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULSHEAR MODERN DENTISTRY,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-13",
        "last_updated": "2016-12-13",
        "status": "A",
        "authorized_official_last_name": "BARNES",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "281-204-2156",
        "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": "Fulshear Modern Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Dec 13, 2016; 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.