| Dentist 101 | |
|
6130 Highway 6 Missouri City TX 77459-3802 | |
| (281) 969-4399 | |
| (281) 969-4398 |
| Full Name | Dentist 101 |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 6130 Highway 6, Missouri City, Texas |
| Authorized Official Name and Position | Jessica Su (OWNER) |
| Authorized Official Contact | 2819694399 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dentist 101 6130 Highway 6 Missouri City TX 77459-3802 Ph: (281) 969-4399 | Dentist 101 6130 Highway 6 Missouri City TX 77459-3802 Ph: (281) 969-4399 |
| NPI Number | 1174470819 |
|---|---|
| Provider Enumeration Date | 03/12/2026 |
| Last Update Date | 08/27/2026 |
| Certification Date | 08/27/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174470819 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | () | Secondary |
| 1223E0200X | Dentist - Endodontics | () | Secondary |
| 1223G0001X | Dentist - General Practice | () | Primary |
| 1223P0300X | Dentist - Periodontics | () | Secondary |
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