NPIMap

Organization Active NPI

Carolyn L Jovanovic PLLC

  • Dental Clinic/Center
  • Conroe, TX
National Provider Identifier
1487239455
Registry record updated Aug 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
CAROLYN L JOVANOVIC PLLC
Practice address
2016 N Loop 336 W
Conroe, TX 77304-3516
Phone
(936) 756-6867
NPI assigned
Mar 11, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2023

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

Authorized official

Name
Dr. Carolyn L. Jovanovic, DDSNPI 1063791267
Title
Dentist
Phone
(936) 756-6867

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

2016 N Loop 336 W
Conroe, TX 77304-3516

Mailing address

2016 N Loop 336 W
Conroe, TX 77304-3516

Other names 1

  • Montgomery Park Dental Doing business as

National Provider Directory

National Provider Directory

Locations

2016 N Loop 336 W
Conroe, TX 77304
Phone (936) 756-6867

Practitioners & affiliated clinicians

Practitioners 5

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": "1615420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692316800000",
    "number": "1487239455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2016 N LOOP 336 W",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773043516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2016 N LOOP 336 W",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773043516",
            "telephone_number": "936-756-6867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLYN L JOVANOVIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-11",
        "last_updated": "2023-08-18",
        "certification_date": "2023-08-18",
        "status": "A",
        "authorized_official_last_name": "JOVANOVIC",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "936-756-6867",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Montgomery Park Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Conroe, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 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.