South Texas Family Dentistry LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

23077 Issued in TX

Legal business name

SOUTH TEXAS FAMILY DENTISTRY LLC

Practice address

8200 Wednesbury LN Ste 108
Houston, TX 77074-2931

Phone

(713) 772-2141

NPI assigned

Jul 8, 2015

Organization subpart

No

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

Authorized official

Name

Shervin Amini

Title

Credentialing Spcialist

Phone

(713) 647-8199

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• South Texas Family Dentistry Doing business as

Locations

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

{
    "created_epoch": "1436313600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629936000000",
    "number": "1629451653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8200 WEDNESBURY LN STE 108",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770742931",
            "telephone_number": "713-772-2141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8200 WEDNESBURY LN STE 108",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770742931",
            "telephone_number": "713-772-2141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH TEXAS FAMILY DENTISTRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-08",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-26",
        "status": "A",
        "authorized_official_last_name": "AMINI",
        "authorized_official_first_name": "SHERVIN",
        "authorized_official_title_or_position": "CREDENTIALING SPCIALIST",
        "authorized_official_telephone_number": "713-647-8199"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "23077",
            "primary": true
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "TX",
            "license": "23077",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "23077",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Texas Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "South Texas Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• South Texas Dental Associates, L.P.
• South Texas Dental Associates, L.P.
• South Texas Dental Associates, L.P.
• South Texas Dental Associates, LP
• South Texas Dental Associates, LP
• South Texas Oncology Center LLC
• South Texas Procedure Suite LLC
• South Texas Surgery Medical Center Inc
• South Texas Trinity Home Health
• South Texas Ultrasound LLC

• Pediatric Dentistry in Houston, TX
• Providers in Houston, TX by specialty
• Pediatric Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2021; 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.