Magnolia Modern Dentistry, PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

MAGNOLIA MODERN DENTISTRY, PC

Practice address

32822 FM 2978
Suite 1300
Magnolia, TX 77354

Phone

(832) 552-1559

NPI assigned

Jul 18, 2024

Organization subpart

No

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

Authorized official

Name

James De Vera

Title

Owner

Phone

(832) 552-1559

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.

• Maxine Mauricio, DDS

  • Dentist
  • Magnolia, TX
  • NPI 1346945664
  NPD

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

{
    "created_epoch": "1721260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721260800000",
    "number": "1902644461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 920050",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753920050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32822 FM 2978",
            "address_2": "SUITE 1300",
            "city": "MAGNOLIA",
            "state": "TX",
            "postal_code": "77354",
            "telephone_number": "832-552-1559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA MODERN DENTISTRY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-18",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-11",
        "status": "A",
        "authorized_official_last_name": "DE VERA",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "832-552-1559"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Magnolia Family Dental and Orthodontics PLLC
• Magnolia Family Dentistry PLLC
• Magnolia Family Therapy
• Magnolia Healthcare Center PA
• Magnolia Isd
• Magnolia Pediatric Therapy
• Magnolia Pharmacy Inc
• Magnolia Smiles Dental PLLC
• Kari Stanton Malone, LPC
• Mariana Gabriela Manescu, NP

• General Practice Dentistry in Magnolia, TX
• Providers in Magnolia, 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 Jul 18, 2024; 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.