Individual provider Active NPI

Afifa Anwar

  • General Practice Dentistry
  • Lake Jackson, TX
National Provider Identifier
1336849322
Registry record updated Aug 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
41516 Issued in TX
Practice address
201 Oak Dr S Ste 206
Lake Jackson, TX 77566-5627
Phone
(979) 205-0542
NPI assigned
Mar 8, 2023
Last updated
Aug 7, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 41516 TX Primary

Addresses

Primary practice location

201 Oak Dr S Ste 206
Lake Jackson, TX 77566-5627

Mailing address

201 Oak Dr S Ste 206
Lake Jackson, TX 77566-5627
Phone (979) 205-0542

Other practice location 1

5620 Fm 1960 Rd W
Houston, TX 77069-4202
Phone (281) 880-9469

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
41516TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Vintage Modern Dentistry, PC General Practice CurrentSince Aug 3, 2025 Accepting new patients

Locations

10927 Louetta Rd
Ste 240
Houston, TX 77070
Phone (713) 885-9153

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1678233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786060800000",
    "number": "1336849322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 OAK DR S STE 206",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775665627",
            "telephone_number": "979-205-0542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 OAK DR S STE 206",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775665627",
            "telephone_number": "979-205-0542"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5620 Fm 1960 Rd W",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770694202",
            "country_code": "US",
            "telephone_number": "281-880-9469",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANWAR",
        "first_name": "AFIFA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-08",
        "last_updated": "2026-08-07",
        "certification_date": "2026-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "41516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Jackson, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2026; 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.