NPIMap

Organization Active NPI

Sealy Kid's Dentistry

  • Pediatric Dentistry
  • Sealy, TX
National Provider Identifier
1629588165
Registry record updated Oct 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
30728 Issued in TX
Legal business name
SEALY KID'S DENTISTRY
Practice address
2355 Highway 36 S
Sealy, TX 77474-4224
Phone
(979) 987-6030
Fax
(979) 476-2035
NPI assigned
Oct 11, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2017

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

Authorized official

Name
Wesley B Zboril, DDSNPI 1740304005
Title
President
Phone
(979) 885-4856

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
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 30728 TX Primary

Addresses

Primary practice location

2355 Highway 36 S
Sealy, TX 77474-4224

Mailing address

2355 Highway 36 S
Sealy, TX 77474-4224
Phone (979) 987-6030

Other identifiers 1

IdentifierTypeStateIssuer
350561201MedicaidTX

National Provider Directory

National Provider Directory

Locations

2355 Highway 36 S
Sealy, TX 77474
Phone (979) 987-6030

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": "1507680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1507680000000",
    "number": "1629588165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2355 HIGHWAY 36 S",
            "city": "SEALY",
            "state": "TX",
            "postal_code": "774744224",
            "telephone_number": "979-987-6030",
            "fax_number": "979-476-2035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2355 HIGHWAY 36 S",
            "city": "SEALY",
            "state": "TX",
            "postal_code": "774744224",
            "telephone_number": "979-987-6030",
            "fax_number": "979-476-2035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEALY KID'S DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-11",
        "last_updated": "2017-10-11",
        "status": "A",
        "authorized_official_last_name": "ZBORIL",
        "authorized_official_first_name": "WESLEY",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "979-885-4856",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "30728",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "350561201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sealy, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 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.