Northwest Pediatric Dental

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

20388 Issued in TX

Legal business name

NORTHWEST PEDIATRIC DENTAL

Practice address

17222 Red Oak Dr
Suite 104
Houston, TX 77090-2648

Phone

(281) 583-4600

Fax

(281) 586-7051

NPI assigned

Jun 4, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Maria A Green, D.D.S

Title

Owner

Phone

(281) 583-4600

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1212537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212537600000",
    "number": "1346409489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17222 RED OAK DR",
            "address_2": "SUITE 104",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770902648",
            "telephone_number": "281-583-4600",
            "fax_number": "281-586-7051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17222 RED OAK DR",
            "address_2": "SUITE 104",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770902648",
            "telephone_number": "281-583-4600",
            "fax_number": "281-586-7051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST PEDIATRIC DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-04",
        "last_updated": "2008-06-04",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "281-583-4600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "20388",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1619062718",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1487709556",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Northwest Nurse Practitioners Clinic, LLC
• Northwest Nursing & Rehabilitation LLC
• Northwest Oncology Clinic, PA
• Northwest Orthopedic Associates, P.a.
• Northwest Outpatient Cancer Center
• Northwest Physicians Associaton
• Northwest Pulmonary Associates
• Northwest Pulmonary Critical Care and Sleep Specialists Inc
• Northwest Surgery Center, LTD
• Northwest Surgical Services Inc

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2008; 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.