Individual provider Active NPI

Babatunde Michael Banwo, DMD

  • General Practice Dentistry
  • Katy, TX
National Provider Identifier
1538898291
Registry record updated Jun 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
38621 Issued in TX
Practice address
24020 Clay Rd Ste 106
Katy, TX 77493-8137
Phone
(832) 400-4129
NPI assigned
Jun 8, 2022
Last updated
Jun 8, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 38621 TX Primary

Addresses

Primary practice location

24020 Clay Rd Ste 106
Katy, TX 77493-8137

Mailing address

14907 Breezy Forest LN
Cypress, TX 77433-4722
Phone (832) 287-7038

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
38621TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Safehavendental LLC CurrentSince Jul 28, 2024 Accepting new patients
Highlands Family Dental LLC General Practice Current Accepting new patients

Locations

10434 Richmond Ave
#A
Houston, TX 77042
Phone (713) 534-1724

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1654646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654646400000",
    "number": "1538898291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14907 BREEZY FOREST LN",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774334722",
            "telephone_number": "832-287-7038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24020 CLAY RD STE 106",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774938137",
            "telephone_number": "832-400-4129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANWO",
        "first_name": "BABATUNDE",
        "middle_name": "MICHAEL",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-08",
        "last_updated": "2022-06-08",
        "certification_date": "2022-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "38621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Katy, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2022; 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.