West Lake Colonnade Dental, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

21713 Issued in TX

Legal business name

WEST LAKE COLONNADE DENTAL, PLLC

Doing business as

West Lake Dental

Practice address

18477 W Lake Houston Pkwy
Suite 80
Humble, TX 77346-3517

Phone

(281) 812-3333

Fax

(281) 812-3332

NPI assigned

Oct 11, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Brandy Michelle Burnett, D.D.S.NPI 1558523027

Title

General Counsel

Phone

(281) 812-3333

Specialties & licenses 1

Addresses

Other names 1

• West Lake Dental Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brandy Michelle Burnett, DDS

  • Dentist
  • Humble, TX
  • NPI 1558523027
  NPD (past) Authorized official

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1427146463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18477 W LAKE HOUSTON PKWY",
            "address_2": "SUITE 80",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773463517",
            "telephone_number": "281-812-3333",
            "fax_number": "281-812-3332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18477 W LAKE HOUSTON PKWY",
            "address_2": "SUITE 80",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773463517",
            "telephone_number": "281-812-3333",
            "fax_number": "281-812-3332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST LAKE COLONNADE DENTAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BURNETT",
        "authorized_official_first_name": "BRANDY",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "GENERAL COUNSEL",
        "authorized_official_telephone_number": "281-812-3333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "21713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Lake Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• What'S Important Now

• General Practice Dentistry in Humble, TX
• Providers in Humble, 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 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.