Immanuel Dental Center

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

IMMANUEL DENTAL CENTER

Practice address

1147 Clear Lake City Blvd
Houston, TX 77062-8102

Phone

(281) 286-5867

Fax

(281) 286-6551

NPI assigned

Apr 27, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Nagy B Ghattas, D.D.S

Title

Dentists

Phone

(281) 286-5867

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1272326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272326400000",
    "number": "1942527213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1147 CLEAR LAKE CITY BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770628102",
            "telephone_number": "281-286-5867",
            "fax_number": "281-286-6551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1147 CLEAR LAKE CITY BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770628102",
            "telephone_number": "281-286-5867",
            "fax_number": "281-286-6551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMMANUEL DENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-27",
        "last_updated": "2010-04-27",
        "status": "A",
        "authorized_official_last_name": "GHATTAS",
        "authorized_official_first_name": "NAGY",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "DENTISTS",
        "authorized_official_telephone_number": "281-286-5867",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "163581501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Immaculate Home Care
• Immaculate Living Care, LLC
• Immaculate Nursing LLC
• Immaculate Transportation LLC
• Nang Immanivong
• Josepha Immanuel, M.D
• Kevin Emitseilu Immanuel, M.D
• Oluchi Ibekwe Immanuel, MD
• Immediate Care Centers LLC
• Immediate Care Group, Inc

• General Practice Dentistry in Houston, TX
• Providers in Houston, 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 Apr 27, 2010; 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.