Organization Active NPI

Mosaic Dental LLC

  • General Practice Dentistry
  • Houston, TX
National Provider Identifier
1477853190
Registry record updated Oct 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
MOSAIC DENTAL LLC
Practice address
15634 Wallisville Rd
Ste 900
Houston, TX 77049-4635
Phone
(281) 864-5073
Fax
(281) 864-5075
NPI assigned
Oct 28, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2010

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

Authorized official

Name
Graciela Rodriguez, DDS
Title
DDS
Phone
(281) 864-5073

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

15634 Wallisville Rd
Ste 900
Houston, TX 77049-4635

Mailing address

15634 Wallisville Rd
Ste 900
Houston, TX 77049-4635
Phone (281) 864-5073

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1288224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288224000000",
    "number": "1477853190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15634 WALLISVILLE RD",
            "address_2": "STE 900",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770494635",
            "telephone_number": "281-864-5073",
            "fax_number": "281-864-5075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15634 WALLISVILLE RD",
            "address_2": "STE 900",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770494635",
            "telephone_number": "281-864-5073",
            "fax_number": "281-864-5075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOSAIC DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-28",
        "last_updated": "2010-10-28",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "GRACIELA",
        "authorized_official_title_or_position": "DDS",
        "authorized_official_telephone_number": "281-864-5073",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2010; 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.