Justin Brock, DDS, MD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

22539 Issued in TX

Practice address

23922 Cinco Village Center Blvd
Suite 111
Katy, TX 77494-6619

Phone

(281) 392-1130

Fax

(281) 392-1643

NPI assigned

May 17, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 12, 2014 through Jan 12, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Bellaire Center for Oral & Facial Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Katy, TX
  • NPI 1386588333
  NPD (past)
• Katy Center for Oral and Facial Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Katy, TX
  • NPI 1053762823
  NPD (past)

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743379200000",
    "number": "1801003074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23922 CINCO VILLAGE CENTER BLVD",
            "address_2": "SUITE 111",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774946619",
            "telephone_number": "281-392-1130",
            "fax_number": "281-392-1643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23922 CINCO VILLAGE CENTER BLVD",
            "address_2": "SUITE 111",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774946619",
            "telephone_number": "281-392-1130",
            "fax_number": "281-392-1643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCK",
        "first_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "DDS, MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-17",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "22539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandi Ann Brittain, LCSW
• Tatiana Britto Da Silveira Sena
• Janet Lee Broadnax
• Emma Grace Broadwater
• Erica Nicole Brobbey, NP
• Ralph Avon Brock II, D.D.S, M.S
• Mary Denise Brockman, MA, CCC(SLP)
• Kaitlyn Brodnax
• Iulia Brodsky, PT ASSISTANT
• Jackie Harding Broni

• Oral and Maxillofacial Surgery (Dentist) in Katy, TX
• Providers in Katy, TX by specialty
• Oral and Maxillofacial Surgery (Dentist) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.