Gulf Family Dental PC

Primary specialty

DentistTaxonomy code 122300000X

License

19896 Issued in TX

Legal business name

GULF FAMILY DENTAL PC

Practice address

3701 Shaver St
Pasadena, TX 77504-2601

Phone

(713) 946-8200

Fax

(713) 946-8203

NPI assigned

Feb 23, 2015

Last updated

Feb 23, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Abdoul R Koroni, DDS

Title

President

Phone

(713) 946-8200

Specialties & licenses 1

Addresses

Other identifiers 2

Tax ID family

Gulf Family Dental PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Gulf Family Dental PC

  • General Practice Dentistry
  • Houston, TX
  • NPI 1669761425
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Joseph Anthony Dibartolo, DDS

  • General Practice Dentistry
  • Pasadena, TX
  • NPI 1003299868
  NPD (past)

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

{
    "created_epoch": "1424649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424649600000",
    "number": "1356733794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3701 SHAVER ST.",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "77504",
            "telephone_number": "713-946-8200",
            "fax_number": "713-946-8203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 SHAVER ST",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775042601",
            "telephone_number": "713-946-8200",
            "fax_number": "713-946-8203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GULF FAMILY DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-23",
        "last_updated": "2015-02-23",
        "status": "A",
        "authorized_official_last_name": "KORONI",
        "authorized_official_first_name": "ABDOUL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "713-946-8200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "19896",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0078305-02",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0078305-04",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gulf Coast Allergy Center, PA
• Gulf Coast Cancer Center of Pasadena
• Gulf Coast Endodontics
• Gulf Coast Endodontics West U PLLC
• Gulf Coast Pathology Program PLLC
• Shreya Gupta
• Josselin Gutierrez Matamoros, PTA
• Evelyn Julissa Gutierrez
• Janney Gonzalez Gutierrez, FNP-C
• Jose Javier Guzman Diaz, MD

• Dentist in Pasadena, TX
• Providers in Pasadena, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2015; 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.