MEDICARE: THE FAMILY DENTAL CENTER LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1023991627
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE FAMILY DENTAL CENTER LLC

Provider Business Mailing Address
First Line	:	14954 MESA DR STE 105
Second Line	:
City	:	HUMBLE
State	:	TX
Zip	:	77396-5902
Country	:	US
Telephone Number	:	281-458-9787
Fax Number	:	281-458-9788

Provider Business Practice Location Address
First Line	:	14954 MESA DR. STE 105
Second Line	:
City	:	HUMBLE
State	:	TX
Zip	:	77396-5902
Country	:	US
Telephone Number	:	281-458-9787
Fax Number	:	281-458-9788

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	WENDE M PINSON
Credential	:
Telephone Number	:	281-458-8797

Provider Enumeration Date	:	07/30/2025
Last Update Date	:	03/25/2026

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