NPIMap

Organization Active NPI

Fouat Bend Dental Associates, PLLC

  • General Practice Dentistry
  • Missouri City, TX
National Provider Identifier
1467432575
Registry record updated Jul 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
FOUAT BEND DENTAL ASSOCIATES, PLLC
Practice address
3717 Township Lane
Missouri City, TX 77459
Phone
(281) 499-3541
Fax
(281) 605-5956
NPI assigned
Jan 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2023

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

Authorized official

Name
Mr. Dwight D Peccora, DDS
Title
Doctor/Managing Partner
Phone
(281) 499-3541

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223E0200X
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary
PeriodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0300X
Oral and Maxillofacial Surgery (Dentist)Group: 193200000X MULTI-SPECIALTY GROUP 1223S0112X

Addresses

Primary practice location

3717 Township Lane
Missouri City, TX 77459

Mailing address

3717 Township Lane
Missouri City, TX 77459
Phone (281) 499-3541

Other names 1

  • Fort Bend Dental Associates, PA Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Fort Bend Dental Associates PA2 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.

Locations

5819 Highway 6
Ste 230
Missouri City, TX 77459
Phone (281) 499-3541

Practitioners & affiliated clinicians

Practitioners 4

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": "1137456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688947200000",
    "number": "1467432575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3717 TOWNSHIP LANE",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "77459",
            "telephone_number": "281-499-3541",
            "fax_number": "281-499-3533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3717 TOWNSHIP LANE",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "77459",
            "telephone_number": "281-499-3541",
            "fax_number": "281-605-5956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUAT BEND DENTAL ASSOCIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-17",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A",
        "authorized_official_last_name": "PECCORA",
        "authorized_official_first_name": "DWIGHT",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DOCTOR/MANAGING PARTNER",
        "authorized_official_telephone_number": "281-499-3541",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fort Bend Dental Associates, PA",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Missouri City, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2023; 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.