Provider Demographics
NPI:1629293444
Name:DE JONGH, DAVID (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:DE JONGH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13141 FM 1960 RD W
Mailing Address - Street 2:SUITE 300
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065-5278
Mailing Address - Country:US
Mailing Address - Phone:832-912-6670
Mailing Address - Fax:832-912-6679
Practice Address - Street 1:13141 FM 1960 RD W
Practice Address - Street 2:SUITE 300
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77065-5278
Practice Address - Country:US
Practice Address - Phone:832-912-6670
Practice Address - Fax:832-912-6679
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2015-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX126491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice