Montgomery Comprehensive Dental Center

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

License

16499 Issued in TX

Legal business name

MONTGOMERY COMPREHENSIVE DENTAL CENTER

Practice address

2210 N Frazier St
Suite #120
Conroe, TX 77303-1780

Phone

(936) 539-3636

Fax

(936) 539-3639

NPI assigned

Apr 29, 2015

Organization subpart

No

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

Authorized official

Name

Miss Rachel D Stark

Title

Financial Coordinator

Phone

(936) 539-3636

Specialties & licenses 1

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kimberly Raabe Espinoza, DDS

  • Dentist
  • Conroe, TX
  • NPI 1487184313
  NPD (past)
• Timothy Elmer Gardner, DDS

  • General Practice Dentistry
  • Conroe, TX
  • NPI 1104043942
  NPD (past)
• Seth Adam Harris, D.D.S.

  • General Practice Dentistry
  • Marble Falls, TX
  • NPI 1245645712
  NPD (past)

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

{
    "created_epoch": "1430265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430265600000",
    "number": "1619354693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "0951 LONESTAR PARKWAY",
            "city": "MONTGOMERY",
            "state": "TX",
            "postal_code": "773560951",
            "telephone_number": "936-230-5445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 N FRAZIER ST",
            "address_2": "SUITE #120",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773031780",
            "telephone_number": "936-539-3636",
            "fax_number": "936-539-3639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTGOMERY COMPREHENSIVE DENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-29",
        "last_updated": "2015-04-29",
        "status": "A",
        "authorized_official_last_name": "STARK",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "FINANCIAL COORDINATOR",
        "authorized_official_telephone_number": "936-539-3636",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "TX",
            "license": "16499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Elizabeth Monheit, M.D.
• Monihealth Home Care Services, Inc. (Total Home Health Conroe)
• Monte Nido Texas, LLC (Clementine Houston)
• Monte Nido Texas, LLC (Monte Nido Houston)
• Ariana Montes
• Montgomery County Cardiovascular Associates PA
• Montgomery County Hospital District
• Montgomery County Hospital District
• Montgomery County Lung Clinic, P.a. (None)
• Montgomery County Periodontal Associates PC

• Exclusive Provider Organization in Conroe, TX
• Providers in Conroe, TX by specialty
• Exclusive Provider Organization in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 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.