Fall Creek Family Dental PLLC

Primary specialty

DentistTaxonomy code 122300000X

License

25991 Issued in TX

Legal business name

FALL CREEK FAMILY DENTAL PLLC

Doing business as

Fall Creek Family Dental

Practice address

9506 N Sam Houston Pkwy E
Ste 230
Humble, TX 77396-4901

Phone

(713) 645-1680

NPI assigned

Jan 28, 2013

Organization subpart

No

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

Authorized official

Name

Gohar Bernal, DMD

Title

Owner

Phone

(713) 645-1680

Specialties & licenses 1

Addresses

Other names 1

• Fall Creek Family Dental Doing business as

Locations

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

{
    "created_epoch": "1359331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359331200000",
    "number": "1760720650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9506 N SAM HOUSTON PKWY E",
            "address_2": "STE 230",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773964901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9506 N SAM HOUSTON PKWY E",
            "address_2": "STE 230",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773964901",
            "telephone_number": "713-645-1680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FALL CREEK FAMILY DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-28",
        "last_updated": "2013-01-28",
        "status": "A",
        "authorized_official_last_name": "BERNAL",
        "authorized_official_first_name": "GOHAR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "713-645-1680",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "25991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fall Creek Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2013; 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.