Texas Dental Group

Primary specialty

DentistTaxonomy code 122300000X

License

21886 Issued in TX

Legal business name

TEXAS DENTAL GROUP

Practice address

608 Everett St
Conroe, TX 77301-1829

Phone

(936) 760-3050

Fax

(936) 441-3068

NPI assigned

Apr 3, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Kenneth Osamor, D.D.S.

Title

Owner

Phone

(936) 760-3050

Specialties & licenses 1

Addresses

Other names 1

• ConroeDental Other name

Locations

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1679694038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 EVERETT ST",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773011829",
            "telephone_number": "936-760-3050",
            "fax_number": "936-441-3068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 EVERETT ST",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773011829",
            "telephone_number": "936-760-3050",
            "fax_number": "936-441-3068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXAS DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "OSAMOR",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "936-760-3050",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "21886",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ConroeDental",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Dentist in Conroe, TX
• Providers in Conroe, TX by specialty
• Dentist in Texas

• 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.