Healthcare Provider Details

I. General information

NPI: 1497405799
Provider Name (Legal Business Name): WINNIE FAMILY DENTAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2022
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

521 HIGHWAY 124 STE A
WINNIE TX
77665-6008
US

IV. Provider business mailing address

3838 N SAM HOUSTON PKWY E STE 430
HOUSTON TX
77032-3418
US

V. Phone/Fax

Practice location:
  • Phone: 832-369-6941
  • Fax:
Mailing address:
  • Phone: 832-369-6941
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: DR. GEETIKA RASTOGI
Title or Position: OWNER
Credential:
Phone: 832-369-6941