Southeast Texas Dental Center

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

SOUTHEAST TEXAS DENTAL CENTER

Practice address

190 N Zavalla St
Jasper, TX 75951-4119

Phone

(409) 384-5091

Fax

(409) 384-5046

NPI assigned

Jul 18, 2012

Organization subpart

No

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

Authorized official

Name

Ms. Carrie Camille Jordan

Title

Business Manager

Phone

(409) 384-5091

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1342569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342569600000",
    "number": "1356696058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 N ZAVALLA ST",
            "city": "JASPER",
            "state": "TX",
            "postal_code": "759514119",
            "telephone_number": "409-384-5091",
            "fax_number": "409-384-5046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 N ZAVALLA ST",
            "city": "JASPER",
            "state": "TX",
            "postal_code": "759514119",
            "telephone_number": "409-384-5091",
            "fax_number": "409-384-5046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST TEXAS DENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-18",
        "last_updated": "2012-07-18",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "CARRIE",
        "authorized_official_middle_name": "CAMILLE",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "409-384-5091",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Ann Simar, FNP-C
• Geeta Singh, MD
• Saurabh Singh, MD
• Joanndara M Slaydon
• Solitude Emergency Physicians, PLLC
• James Berthold Spencer, M.D.
• Steven G. Spencer, DDS
• Jimmy W. Spruill, M.D.
• Vicky St John, APRN
• Stat Services of Jasper County a, LLP (Stat Care EMS)

• General Practice Dentistry in Jasper, TX
• Providers in Jasper, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2012; 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.