NPIMap

Organization Active NPI

Michael R McCulloch DDS PC

  • Dentist
  • Katy, TX
National Provider Identifier
1619045044
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
11730 Issued in TX
Legal business name
MICHAEL R MCCULLOCH DDS PC
Practice address
23020 Highland Knolls #B
Katy, TX 77494-8257
Phone
(281) 693-6427
Fax
(281) 693-4258
NPI assigned
Dec 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Michael Ray McCulloch, DDSNPI 1891935367
Title
President Owner
Phone
(281) 693-6427

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
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 11730 TX Primary

Addresses

Primary practice location

23020 Highland Knolls #B
Katy, TX 77494-8257

Mailing address

23020 Highland Knolls #B
Katy, TX 77494-8257
Phone (281) 693-6427

National Provider Directory

National Provider Directory

Locations

23020 Highland Knolls Blvd
Ste B
Katy, TX 77494
Phone (281) 503-4068

Practitioners & affiliated clinicians

Practitioners 2

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": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1619045044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23020 HIGHLAND KNOLLS #B",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774948257",
            "telephone_number": "281-693-6427",
            "fax_number": "281-693-4258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23020 HIGHLAND KNOLLS #B",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774948257",
            "telephone_number": "281-693-6427",
            "fax_number": "281-693-4258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL R MCCULLOCH DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCCULLOCH",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "RAY",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "281-693-6427",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "11730",
            "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 Aug 22, 2020; 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.