NPIMap

Organization Active NPI

Fort Bend Dental Associates, PLLC

  • Dentist
  • Missouri City, TX
National Provider Identifier
1609231372
Registry record updated Dec 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
25645 Issued in TX
Legal business name
FORT BEND DENTAL ASSOCIATES, PLLC
Practice address
5819 Highway 6 Ste 230
Missouri City, TX 77459-4070
Phone
(281) 499-3541
NPI assigned
Dec 23, 2015
Last updated
Dec 23, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
DDS PARTNERS HOLDINGS LLLPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 23, 2015

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

Authorized official

Name
Dwight Peccora, DDSNPI 1124330782
Title
Dentist - Partner
Phone
(281) 499-3541

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 25645 TX Primary

Addresses

Primary practice location

5819 Highway 6 Ste 230
Missouri City, TX 77459-4070

Mailing address

5819 Highway 6 Ste 230
Missouri City, TX 77459-4070
Phone (281) 499-3541

National Provider Directory

National Provider Directory
Tax ID family
Fort Bend Dental Associates PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5819 Highway 6
Ste 230
Missouri City, TX 77459
Phone (281) 499-3541

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1450828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450828800000",
    "number": "1609231372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5819 HIGHWAY 6 STE 230",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "774594070",
            "telephone_number": "281-499-3541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5819 HIGHWAY 6 STE 230",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "774594070",
            "telephone_number": "281-499-3541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT BEND DENTAL ASSOCIATES, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DDS PARTNERS HOLDINGS LLLP",
        "enumeration_date": "2015-12-23",
        "last_updated": "2015-12-23",
        "status": "A",
        "authorized_official_last_name": "PECCORA",
        "authorized_official_first_name": "DWIGHT",
        "authorized_official_title_or_position": "DENTIST - PARTNER",
        "authorized_official_telephone_number": "281-499-3541",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "25645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missouri City, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2015; 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.