Active NPI
Stephen Vargo
- General Practice Dentistry
- Conroe, TX
National Provider Identifier
1750764858
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 31207
- Practice address
- 2040 N Loop 336 W Ste 207
Conroe, TX 77304-3580 - Phone
- (936) 756-2420
- NPI assigned
- Jul 7, 2015
- Last updated
- Aug 9, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 31207 | TX | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X | NU |
Addresses
Primary practice location
2040 N Loop 336 W Ste 207
Conroe, TX 77304-3580
Mailing address
2040 N Loop 336 W Ste 207
Conroe, TX 77304-3580
Other practice location 1
6818 Fawncliff Dr
Houston, TX 77069-3107
Phone (832) 242-4337
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31207 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Conroe Advanced Dentistry, PLLC | Current | Accepting new patients |
Locations
2040 N Loop 336 W
Ste 207
Conroe, TX 77304
Phone (936) 756-2420
Interoperability endpoints
- svargo76413@directhoustonmethodist.org
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Conroe Advanced Dentistry
- Dental Clinic/Center
- Conroe, TX
- NPI 1104495209
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1436227200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660003200000",
"number": "1750764858",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2040 N LOOP 336 W STE 207",
"city": "CONROE",
"state": "TX",
"postal_code": "773043580"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2040 N LOOP 336 W STE 207",
"city": "CONROE",
"state": "TX",
"postal_code": "773043580",
"telephone_number": "936-756-2420"
}
],
"practiceLocations": [
{
"address_1": "6818 Fawncliff Dr",
"address_purpose": "LOCATION",
"city": "Houston",
"state": "TX",
"postal_code": "770693107",
"country_code": "US",
"telephone_number": "832-242-4337",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VARGO",
"first_name": "STEPHEN",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-07-07",
"last_updated": "2022-08-09",
"certification_date": "2022-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "31207",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Conroe, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 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.