Hollywood Dentist Four

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30127 Issued in TX

Legal business name

HOLLYWOOD DENTIST FOUR

Practice address

12620 Woodforest Blvd Ste 420a
Houston, TX 77015-3643

Phone

(713) 637-8000

Fax

(713) 637-6558

NPI assigned

Jan 28, 2015

Last updated

Jan 28, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jeffrey M. Tang, D.D.SNPI 1942617378

Title

Owner

Phone

(713) 637-8000

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Jeffrey Tang, D.D.S.

  • General Practice Dentistry
  • Houston, TX
  • NPI 1942617378
  Authorized official Same address or phone

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

{
    "created_epoch": "1422403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422403200000",
    "number": "1619367612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12620 WOODFOREST BLVD STE 420A",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770153643",
            "telephone_number": "713-637-8000",
            "fax_number": "713-637-6558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12620 WOODFOREST BLVD STE 420A",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770153643",
            "telephone_number": "713-637-8000",
            "fax_number": "713-637-6558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLLYWOOD DENTIST FOUR",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-28",
        "last_updated": "2015-01-28",
        "status": "A",
        "authorized_official_last_name": "TANG",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "713-637-8000",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "30127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Holly Health Services, Inc. (Holly Health Services)
• Holly Knudsen Varner, MD PA
• Holly L Huston PHD PA
• Kaila A Holly
• Hollywood Corporation (Hollywood Dental)
• Hollywood Dentists LLC
• Hollywood Dentists One
• Hollywood Dentists Two
• Bonnie Elizabeth Hollywood, MA CCCSLP
• Kyle Hollywood

• General Practice Dentistry in Houston, TX
• Providers in Houston, 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 Jan 28, 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.