Everest Dental Conroe Corporation

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

22638 Issued in TX

Legal business name

EVEREST DENTAL CONROE CORPORATION

Practice address

2104 N Frazier St Ste D
Conroe, TX 77301-1250

Phone

(936) 756-5080

Fax

(936) 727-2786

NPI assigned

Sep 19, 2017

Last updated

Sep 19, 2017By 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

Dr. Loc Bui, DDS

Title

President

Phone

(832) 881-6868

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1505779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505779200000",
    "number": "1619496882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2104 N FRAZIER ST STE D",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773011250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2104 N FRAZIER ST STE D",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773011250",
            "telephone_number": "936-756-5080",
            "fax_number": "936-727-2786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVEREST DENTAL CONROE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-19",
        "last_updated": "2017-09-19",
        "status": "A",
        "authorized_official_last_name": "BUI",
        "authorized_official_first_name": "LOC",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "832-881-6868",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "TX",
            "license": "22638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dental Clinic/Center in Conroe, TX
• Providers in Conroe, TX by specialty
• Dental Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2017; 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.