Citydds, PLLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

CITYDDS, PLLC

Practice address

17100 Glenmount Park Dr
Webster, TX 77598-4368

Phone

(281) 488-2483

NPI assigned

Dec 21, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Joseph B Ilustre, DDSNPI 1417107384

Title

President

Phone

(832) 863-2702

Specialties & licenses 3

Addresses

Practitioners 1

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

• Joseph Bryan Ilustre, D.D.S

  • General Practice Dentistry
  • Pearland, TX
  • NPI 1417107384
  NPD Authorized official

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

{
    "created_epoch": "1703116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703116800000",
    "number": "1316716129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17100 GLENMOUNT PARK DR",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775984368",
            "telephone_number": "281-488-2483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17100 GLENMOUNT PARK DR",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775984368",
            "telephone_number": "281-488-2483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITYDDS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-21",
        "last_updated": "2023-12-21",
        "certification_date": "2023-12-21",
        "status": "A",
        "authorized_official_last_name": "ILUSTRE",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "832-863-2702",
        "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": false
        },
        {
            "code": "1223D0004X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Dental Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samiha Tahsin Choudhury
• Melanie Andree Furtney Christofferson, D.O.
• Addison Lynn Ciavaglia-Brown, MD
• Tiffany N Citty I, MS-CCC-SLP
• City of Webster
• CL Medical Associates II Inc
• Gregory T Clariday, M D
• Deanna Clark, BCBA
• Christine Elaine Clarke, APRN, FNP-C
• Lewis K Clarke, M.D.

• Pediatric Dentistry in Webster, TX
• Providers in Webster, TX by specialty
• Pediatric Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2023; 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.