NPIMap

Organization Active NPI

Kingsland Dental Group, P.a.

  • Dentist
  • Katy, TX
National Provider Identifier
1629291679
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
14823 Issued in TX
Legal business name
KINGSLAND DENTAL GROUP, P.A.
Practice address
21681 Kingsland Blvd
Katy, TX 77450-2512
Phone
(281) 646-8888
Fax
(281) 646-8885
NPI assigned
Apr 10, 2007
Last updated
Aug 22, 2020By the provider in NPPES
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. Bridget Holmes Tissue, D.D.S.NPI 1750539292
Title
Owner
Phone
(281) 646-8888

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 14823 TX Primary

Addresses

Primary practice location

21681 Kingsland Blvd
Katy, TX 77450-2512

Mailing address

21681 Kingsland Blvd
Katy, TX 77450-2512
Phone (281) 646-8888

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1629291679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21681 KINGSLAND BLVD",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774502512",
            "telephone_number": "281-646-8888",
            "fax_number": "281-646-8885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21681 KINGSLAND BLVD",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774502512",
            "telephone_number": "281-646-8888",
            "fax_number": "281-646-8885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINGSLAND DENTAL GROUP, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TISSUE",
        "authorized_official_first_name": "BRIDGET",
        "authorized_official_middle_name": "HOLMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "281-646-8888",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "14823",
            "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.