NPIMap

Organization Active NPI

Montgomery County Periodontal Associates PC

  • Periodontics
  • Conroe, TX
National Provider Identifier
1962848226
Registry record updated May 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
Legal business name
MONTGOMERY COUNTY PERIODONTAL ASSOCIATES PC
Practice address
601 River Pointe Dr
Ste 110
Conroe, TX 77304-2945
Phone
(281) 363-2009
Fax
(281) 367-5622
NPI assigned
May 14, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2013

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

Authorized official

Name
Dr. Michael S Dwyer, BA,DDS,MS
Title
Owner
Phone
(281) 363-2009

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0300X Primary

Addresses

Primary practice location

601 River Pointe Dr
Ste 110
Conroe, TX 77304-2945

Mailing address

601 River Pointe Dr
Ste 110
Conroe, TX 77304-2945
Phone (281) 363-2009

National Provider Directory

National Provider Directory
Tax ID family
Montgomery County Periodontal Associates PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1368489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368489600000",
    "number": "1962848226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 RIVER POINTE DR",
            "address_2": "STE 110",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773042945",
            "telephone_number": "281-363-2009",
            "fax_number": "281-367-5622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 RIVER POINTE DR",
            "address_2": "STE 110",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773042945",
            "telephone_number": "281-363-2009",
            "fax_number": "281-367-5622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTGOMERY COUNTY PERIODONTAL ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-14",
        "last_updated": "2013-05-14",
        "status": "A",
        "authorized_official_last_name": "DWYER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "281-363-2009",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "BA,DDS,MS"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "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, 2013; 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.