Village Park Family Dental LLC

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

VILLAGE PARK FAMILY DENTAL LLC

Practice address

12617 Louetta Rd Ste 204
Cypress, TX 77429-5212

Phone

(281) 336-1131

Fax

(888) 433-8848

NPI assigned

May 19, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Saba Ahmed, DDS

Title

Doctor

Phone

(218) 336-1131

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Village Park Family Dental Doing business as

Locations

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

{
    "created_epoch": "1431993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435190400000",
    "number": "1750760179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12617 LOUETTA RD STE 204",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774295212",
            "telephone_number": "281-336-1131",
            "fax_number": "888-433-8848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12617 LOUETTA RD STE 204",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774295212",
            "telephone_number": "281-336-1131",
            "fax_number": "888-433-8848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE PARK FAMILY DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-19",
        "last_updated": "2015-06-25",
        "status": "A",
        "authorized_official_last_name": "AHMED",
        "authorized_official_first_name": "SABA",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "218-336-1131",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "23508",
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "23508",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Village Park Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Case Management Agency in Cypress, TX
• Providers in Cypress, TX by specialty
• Case Management Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 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.