Baybrook Mall Dental PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN16377 Issued in FL

Legal business name

BAYBROOK MALL DENTAL PC

Practice address

1012 Baybrook Mall
Friendswood, TX 77546-2744

Phone

(281) 461-6515

NPI assigned

Feb 21, 2013

Last updated

Dec 4, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Rostislav Krasnov, DDS

Title

Owner

Phone

(917) 902-9515

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Vlada Matytsin, D.D.S

  • General Practice Dentistry
  • Sugar Land, TX
  • NPI 1003964339
  NPD (past)

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

{
    "created_epoch": "1361404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417651200000",
    "number": "1861732273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1012 BAYBROOK MALL",
            "city": "FRIENDSWOOD",
            "state": "TX",
            "postal_code": "775462744",
            "telephone_number": "281-461-6515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1012 BAYBROOK MALL",
            "city": "FRIENDSWOOD",
            "state": "TX",
            "postal_code": "775462744",
            "telephone_number": "281-461-6515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYBROOK MALL DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-21",
        "last_updated": "2014-12-04",
        "status": "A",
        "authorized_official_last_name": "KRASNOV",
        "authorized_official_first_name": "ROSTISLAV",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-902-9515",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN16377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lynda Barker, MSN, RN, ANP, PMHNP
• Tracey Dianne Barr, P. T.
• Bay Area Consultationand Associates, LLC
• Bay Area Psychiatry Group PLLC
• Bay Pointe Behavioral Health Service, Inc.
• Baybrook Modern Eyecare, P.L.L.C (Baybrook Modern Eyecare)
• Baybrook Vision Center Inc (Optometry Group)
• Haleigh Beaird, MT-BC
• Bear Creek Behavioral Health (n/a)
• Sandra Beaugh, CPHT

• General Practice Dentistry in Friendswood, TX
• Providers in Friendswood, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2014; 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.