Organization Active NPI

Endodontics & Microsurgery Center PC

  • Endodontics
  • Katy, TX
National Provider Identifier
1790349165
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
Legal business name
ENDODONTICS & MICROSURGERY CENTER PC
Practice address
23543 Kingsland Blvd Ste 500
Katy, TX 77494-3962
Phone
(281) 655-8445
Fax
(346) 257-4962
NPI assigned
Apr 30, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Authorized official

Name
Paula Andrea Mendez Montalvo, D.D.S.
Title
Co-Owner/Endodontist
Phone
(281) 655-8445

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223E0200X Primary

Addresses

Primary practice location

23543 Kingsland Blvd Ste 500
Katy, TX 77494-3962

Mailing address

23543 Kingsland Blvd Ste 500
Katy, TX 77494-3962
Phone (281) 655-8445

Other identifiers 1

IdentifierTypeStateIssuer
25824OtherTXTEXAS DENTAL LICENSE NUMBER

National Provider Directory

National Provider Directory

Locations

23543 Kingsland Blvd
Ste 500
Katy, TX 77494
Phone (281) 655-8445

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1556582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1790349165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23543 KINGSLAND BLVD STE 500",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774943962",
            "telephone_number": "281-655-8445",
            "fax_number": "346-257-4962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23543 KINGSLAND BLVD STE 500",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774943962",
            "telephone_number": "281-655-8445",
            "fax_number": "346-257-4962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENDODONTICS & MICROSURGERY CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-30",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "MENDEZ MONTALVO",
        "authorized_official_first_name": "PAULA",
        "authorized_official_middle_name": "ANDREA",
        "authorized_official_title_or_position": "CO-OWNER/ENDODONTIST",
        "authorized_official_telephone_number": "281-655-8445",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS DENTAL LICENSE NUMBER",
            "identifier": "25824",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Katy, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.