NPIMap

Organization Active NPI

Webster Dental Associates

  • Dentist
  • Webster, TX
National Provider Identifier
1356445928
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12330 Issued in TX
Legal business name
WEBSTER DENTAL ASSOCIATES
Practice address
17240 Mill Forest LN
Ste B
Webster, TX 77598-4366
Phone
(281) 280-8111
Fax
(281) 280-8525
NPI assigned
Sep 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Benjamin Evans Smith Jr., DDSNPI 1932296886
Title
Owner
Phone
(281) 280-8111

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 12330 TX Primary

Addresses

Primary practice location

17240 Mill Forest LN
Ste B
Webster, TX 77598-4366

Mailing address

17240 Mill Forest LN
Ste B
Webster, TX 77598-4366
Phone (281) 280-8111

Other identifiers 3

IdentifierTypeStateIssuer
84D541OtherTXBCBS
121808OtherUNITED CONCORDIA
TX0D15730OtherTXBCBS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1158019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1356445928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17240 MILL FOREST LN",
            "address_2": "STE B",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775984366",
            "telephone_number": "281-280-8111",
            "fax_number": "281-280-8525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17240 MILL FOREST LN",
            "address_2": "STE B",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775984366",
            "telephone_number": "281-280-8111",
            "fax_number": "281-280-8525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEBSTER DENTAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "EVANS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "281-280-8111",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "12330",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "84D541",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "121808",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "TX0D15730",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Webster, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.