Organization Active NPI

Willow Park Dental Center PA

  • Dentist
  • Houston, TX
National Provider Identifier
1619087970
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
18838 Issued in TX
Legal business name
WILLOW PARK DENTAL CENTER PA
Practice address
13715 Tomball Parkway
Houston, TX 77086
Phone
(281) 260-8888
Fax
(281) 260-8593
NPI assigned
Aug 30, 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
Dr. Tu Ren, DDSNPI 1164575585
Title
President Dentist
Phone
(281) 543-8520

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 18838 TX Primary

Addresses

Primary practice location

13715 Tomball Parkway
Houston, TX 77086

Mailing address

13715 Tomball Parkway
Houston, TX 77086
Phone (281) 543-8520

Other identifiers 1

IdentifierTypeStateIssuer
B188381OtherTXDELTA CHIP

National Provider Directory

National Provider Directory

Locations

13715 Tomball Pkwy
Houston, TX 77086
Phone (281) 260-8888

Practitioners & affiliated clinicians

Practitioners 1

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": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1619087970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13715 TOMBALL PARKWAY",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77086",
            "telephone_number": "281-543-8520",
            "fax_number": "281-260-8593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13715 TOMBALL PARKWAY",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77086",
            "telephone_number": "281-260-8888",
            "fax_number": "281-260-8593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOW PARK DENTAL CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "REN",
        "authorized_official_first_name": "TU",
        "authorized_official_title_or_position": "PRESIDENT DENTIST",
        "authorized_official_telephone_number": "281-543-8520",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "18838",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA CHIP",
            "identifier": "B188381",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, 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.