Willowplace Star Dental

Primary specialty

Public Health DentistryTaxonomy code 1223D0001X

Legal business name

WILLOWPLACE STAR DENTAL

Practice address

17350 State Highway 249 Ste 340
Houston, TX 77064-1139

Phone

(832) 869-4185

NPI assigned

May 23, 2022

Last updated

Jun 13, 2022By 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

Young Shim, DMDNPI 1790011609

Title

Manager

Phone

(404) 512-0760

Specialties & licenses 1

Addresses

Locations

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.

• Young Tae Shim, DMD

  • Dentist
  • Duluth, GA
  • NPI 1790011609
  Authorized official Same address or phone

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

{
    "created_epoch": "1653264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655078400000",
    "number": "1710625470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17350 STATE HIGHWAY 249 STE 340",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770641139",
            "telephone_number": "832-869-4185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17350 STATE HIGHWAY 249 STE 340",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770641139",
            "telephone_number": "832-869-4185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOWPLACE STAR DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-23",
        "last_updated": "2022-06-13",
        "certification_date": "2022-06-13",
        "status": "A",
        "authorized_official_last_name": "SHIM",
        "authorized_official_first_name": "YOUNG",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "404-512-0760",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Willowbrook SNF Management LLC (Willowbrook Residence and Rehabilitation Center)
• Willowbrook Spine Center, P.a. (The Spine Center)
• Willowbrook Surgery Center LTD
• Willowbrook Tso PC (Willowbrook Texas State Optical)
• Willowchase Medical PLLC
• Temica Latrice Willrich, CPHT
• Patricia Wills Bagnato, PNP
• Elizabeth K Wills, LPC
• Lachaca Tawan Wills, CRNA
• Patrick Wayne Wills, MD

• Public Health Dentistry in Houston, TX
• Providers in Houston, TX by specialty
• Public Health Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2022; 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.