TLN Family & Cosmetic Dental @ Pearland Parkway

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

22283 Issued in TX

Legal business name

TLN FAMILY & COSMETIC DENTAL @ PEARLAND PARKWAY

Practice address

2701 Pearland Parkway
Suite 201
Pearland, TX 77581

Phone

(713) 723-2600

NPI assigned

Oct 12, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Tammeka Nickleberry, DDS

Title

Ceo

Phone

(713) 723-2600

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1444608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444608000000",
    "number": "1730550161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 GENOVA WAY LANE",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "77459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 PEARLAND PARKWAY",
            "address_2": "SUITE 201",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "77581",
            "telephone_number": "713-723-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TLN FAMILY & COSMETIC DENTAL @ PEARLAND PARKWAY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-12",
        "last_updated": "2015-10-12",
        "status": "A",
        "authorized_official_last_name": "NICKLEBERRY",
        "authorized_official_first_name": "TAMMEKA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "713-723-2600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "TX",
            "license": "22283",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "176205602",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Preferred Provider Organization in Pearland, TX
• Providers in Pearland, TX by specialty
• Preferred Provider Organization in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2015; 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.