Healthcare Provider Details

I. General information

NPI: 1306712914
Provider Name (Legal Business Name): TLN FAMILY & COSMETIC DENTISTRY AT CYPRESS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2025
Last Update Date: 10/13/2025
Certification Date: 10/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12904 FRY RD STE 500
CYPRESS TX
77433-6904
US

IV. Provider business mailing address

10259 S POST OAK RD
HOUSTON TX
77096-4306
US

V. Phone/Fax

Practice location:
  • Phone: 713-723-2600
  • Fax: 832-377-4791
Mailing address:
  • Phone: 713-723-2600
  • Fax: 832-377-4791

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: TAMMEKA NICKLEBERRY
Title or Position: OWNER/CEO
Credential: DDS
Phone: 832-654-2143