Pioneer Dentistry of Willis, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

PIONEER DENTISTRY OF WILLIS, PLLC

Practice address

12501 Canyon Falls Blvd
Willis, TX 77318-5825

Phone

(936) 931-4462

NPI assigned

Jun 30, 2017

Organization subpart

No

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

Authorized official

Name

Okey Okechukwu

Title

DDS

Phone

(936) 856-3900

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1498780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652227200000",
    "number": "1578084406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12501 CANYON FALLS BLVD STE F",
            "city": "WILLIS",
            "state": "TX",
            "postal_code": "773185809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12501 CANYON FALLS BLVD",
            "city": "WILLIS",
            "state": "TX",
            "postal_code": "773185825",
            "telephone_number": "936-931-4462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIONEER DENTISTRY OF WILLIS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-30",
        "last_updated": "2022-05-11",
        "certification_date": "2022-05-11",
        "status": "A",
        "authorized_official_last_name": "OKECHUKWU",
        "authorized_official_first_name": "OKEY",
        "authorized_official_title_or_position": "DDS",
        "authorized_official_telephone_number": "936-856-3900"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Ondieki, PHARM D
• Jason Ottinger
• Robert Dylan Parker
• Chantelle Renee Paul, D.C.
• Sybil Philip, PHARM. D.
• Jessica Pioquinto, LMSW
• Premise Health of Texas Medical PA (Willis ISD)
• PSC Inc. (Professional Home Oxygen)
• Lorena Quintana Gallion, LCSW
• Radphysicians PLLC

• General Practice Dentistry in Willis, TX
• Providers in Willis, 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 May 11, 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.