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NPI Code Detail

MEDICARE: NATHANIEL CONRAD CEJKA DDS

MEDICARE: NATHANIEL CONRAD CEJKA DDS
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
11223G0001XGeneral Practice DentistryDEN-10762CO
21223G0001XGeneral Practice Dentistry39240TX

General Provider Information

NPI Number : 1215291885
Entity Type Code : Individual
Provider Name (Legal Business Name) : NATHANIEL CONRAD CEJKA DDS
Provider Business Mailing Address
First Line : 9205 EAGLE DR STE 100
Second Line :
City : MONT BELVIEU
State : TX
Zip : 77523-5620
Country : US
Telephone Number : 812-414-2492
Fax Number :
Provider Business Practice Location Address
First Line : 9205 EAGLE DR STE 100
Second Line :
City : MONT BELVIEU
State : TX
Zip : 77523-5620
Country : US
Telephone Number : 281-241-4249
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2012
Last Update Date : 06/13/2025

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Directions to “ NATHANIEL CONRAD CEJKA DDS” Practice Location

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