Lake Conroe Dentistry, PC
Dentist in Conroe, TX. Organization (NPI-2).
NPI number1457790982
StatusActive
Last updated in NPPESJun 18, 2013
Details
- NPI
- 1457790982
- Entity type
- Organization (NPI-2)
- Legal business name
- Lake Conroe Dentistry, PC
- Organization subpart
- No
- Enumeration date
- Jun 18, 2013
- Last updated
- Jun 18, 2013
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | – | – | Yes |
Other names
- Lake Conroe Dentistry (Doing Business As)
Practice location
3915 West Davis StreetSuite 160
Conroe, TX 77304
Phone 936-760-2800 · Fax 936-760-2801
Mailing address
17000 Red Hill AveIrvine, CA 92614-5626
Phone 714-845-8890 · Fax 949-474-1495
Authorized official
John S Barnes
Owner
9367602800
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