Alex Long, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1001538-15 Issued in WI

Practice address

1805 W White Oak Ter Ste a
Conroe, TX 77304-3456

Phone

(414) 840-2822

NPI assigned

Jun 14, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jun 26, 2017 through Jun 26, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1497398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695945600000",
    "number": "1487184248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "229 E FRANKLIN ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549115434",
            "telephone_number": "920-332-6691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 W WHITE OAK TER STE A",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773043456",
            "telephone_number": "414-840-2822"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1720 Congress Ave",
            "address_purpose": "LOCATION",
            "city": "Oshkosh",
            "state": "WI",
            "postal_code": "549017701",
            "country_code": "US",
            "telephone_number": "920-235-3251",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LONG",
        "first_name": "ALEX",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-14",
        "last_updated": "2023-09-29",
        "certification_date": "2023-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "1001538-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lone Star Community Health Center, Inc.
• Lone Star Community Health Center, Inc.
• Lone Star Community Health Center, Inc.
• Lone Star Home Dialysis Limited
• Lonestar Eyecare Associates PC
• Jessica Long
• Kristi D Long, NCC, LPC, LCDC
• Christie Loop, RN, NC-BC
• Geri Zade Depasupil Loot
• Alan Lopes, D.D.S.

• General Practice Dentistry in Conroe, TX
• Providers in Conroe, 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 Sep 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.