NPIMap

Organization Active NPI

Charles J Portales DDS PC

  • General Practice Dentistry
  • Conroe, TX
National Provider Identifier
1801063151
Registry record updated May 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
19018 Issued in TX
Legal business name
CHARLES J PORTALES DDS PC
Practice address
2101 Maurel
Conroe, TX 77304-1231
Phone
(936) 441-3363
Fax
(936) 494-2189
NPI assigned
May 14, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2008

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

Authorized official

Name
Dr. Charles J Portales, DDSNPI 1881774750
Title
Owner
Phone
(936) 441-3363

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 19018 TX Primary

Addresses

Primary practice location

2101 Maurel
Conroe, TX 77304-1231

Mailing address

2101 Maurel
Conroe, TX 77304-1231
Phone (936) 441-3363

National Provider Directory

National Provider Directory

Locations

2101 Maurel
Conroe, TX 77304
Phone (936) 441-3363

Practitioners & affiliated clinicians

Practitioners 3

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": "1210723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210723200000",
    "number": "1801063151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 MAUREL",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773041231",
            "telephone_number": "936-441-3363",
            "fax_number": "936-494-2189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 MAUREL",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773041231",
            "telephone_number": "936-441-3363",
            "fax_number": "936-494-2189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES J PORTALES DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-14",
        "last_updated": "2008-05-14",
        "status": "A",
        "authorized_official_last_name": "PORTALES",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "936-441-3363",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "19018",
            "primary": true
        }
    ],
    "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 May 14, 2008; 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.