SPACE CITY SMILES (NPI# 1750879912) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750879912 |
| Entity Type | Organization |
| Organization Name | SPACE CITY SMILES |
| Practice Address |
2415 Blalock Rd. Suite A Houston TX 77080 |
| Practice Telephone | 8323805149 |
| Mailing Telephone | 8323805149 |
| Enumeration Date | 2018-04-24 |
| Last Update Date | 2018-04-24 |
| Authorized Official Name | JOHNATHAN PHAN (MANAGER) |
| Authorized Official Telephone | 7133631338 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| Street Address |
2415 BLALOCK RD. SUITE A |
| City | HOUSTON |
| State | TX |
| Zip Code | 77080 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760081715 | Valescere Spring Branch | Case Management | 10005 Lazy Oaks Dr, Houston, TX 77080 | 2020-10-21 |
| 1699323519 | Jainy Thomas | Family Medicine | Panamericana Family Medicine, 1900 Blalock Rd, Houston, TX 77080 | 2019-09-04 |
| 1700433760 | Kate Okoroafo | Nurse Practitioner | 3043 Gessner Dr, Houston, TX 77080 | 2019-08-23 |
| 1770088056 | Pura Dental | Clinic/Center | 1507 Gessner Dr. Ste B, Houston, TX 77080 | 2018-03-28 |
| 1356615793 | Nk Dental, P.a. | Dentist | 10139 Hammerly Blvd., Houston, TX 77080 | 2012-03-02 |
| 1700164829 | Carolina Velez Isaza | Emergency Medicine | 8833 Lakeshore Bend Dr, Houston, TX 77080 | 2011-07-22 |
| 1598990772 | Francisco G Lopez Godoy | Family Medicine | 1900 Blalock Rd, Ste M, Houston, TX 77080 | 2009-05-18 |
| 1457519977 | Courtney Sanderson | Speech-Language Pathologist | 3205 Elegia Dr., Houston, TX 77080 | 2008-05-30 |
| 1144492539 | Lamborghini Technologies | Durable Medical Equipment & Medical Supplies | 2870 Gessner Rd. Suite A3, Houston, TX 77080 | 2008-03-26 |
| 1811176217 | Lisa Marie Butler | Counselor | 36 N Wickerwood, Houston, TX 77080 | 2007-11-01 |
| Find all providers in zip 77080 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184237281 | Tbd, Pllc | Clinic/Center | 6363 San Felipe St Ste 200b, Houston, TX 77057-2704 | 2020-08-28 |
| 1770100984 | Tamaara Morris Dds Ms Pllc | Clinic/Center | 5802 Val Verde St Ste 170, Houston, TX 77057-5759 | 2020-07-03 |
| 1891311510 | Wallisville Braces, Pllc | Clinic/Center | 14570 Wallisville Rd Ste 1, Houston, TX 77049-4300 | 2020-06-18 |
| 1326660549 | Dental Clinics of Texas, Pllc | Clinic/Center | 17440 Fm 529 Rd Ste 100, Houston, TX 77095-1167 | 2020-05-11 |
| 1750913711 | Tanglewood Court | Clinic/Center | 5885 San Felipe St Ste 525, Houston, TX 77057-3434 | 2020-02-07 |
| 1730719345 | American Modern Dental | Clinic/Center | 5440 El Dorado Blvd Ste 1600, Houston, TX 77059-5001 | 2020-01-22 |
| 1427609981 | Ondon, Pllc | Clinic/Center | 10211 Cypresswood Dr, Houston, TX 77070-3407 | 2019-09-26 |
| 1205485794 | Gregory Palmer Dmd PC | Clinic/Center | 9113 Stella Link Rd Ste 1, Houston, TX 77025-3930 | 2019-09-06 |
| 1295383347 | M&m Smiles | Clinic/Center | 2522 Yale St Ste 210, Houston, TX 77008-2149 | 2019-09-02 |
| 1841845518 | Memorial City Smiles | Clinic/Center | 902 Frostwood Dr Ste 166, Houston, TX 77024-2449 | 2019-08-08 |
| Find all providers in HOUSTON | ||||
Please comment or provide details below to improve the information on SPACE CITY SMILES.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.