BLUEBONNET PEDIATRIC DENTISTRY PLLC NPI 1114646676

NPI Information

  • NPI: 1114646676
  • Provider Name: BLUEBONNET PEDIATRIC DENTISTRY PLLC
  • Classification: Dentist - 1223P0221X
  • Specialization: Pediatric Dentistry
  • Entity Type: Organization
  • Doing Business As: BLUEBONNET PEDIATRIC DENTISTRY
  • Address: 2650 BECKER DRIVE
    BRENHAM, TX
    ZIP 77833
  • Phone: (979) 451-6026

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NPI Details

BLUEBONNET PEDIATRIC DENTISTRY PLLC is a pediatric dentistry dentist in Brenham, TX. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. BLUEBONNET PEDIATRIC DENTISTRY PLLC NPI is 1114646676. The provider is registered as an organization entity type.
The provider Is Doing Business As Bluebonnet Pediatric Dentistry.

The provider's business location address is:

2650 BECKER DRIVE
BRENHAM, TX
ZIP 77833
Phone: (979) 451-6026
Fax: (979) 246-0960

The provider's authorized official is Jonathan Charles Ames .
The authorized official title is Owner/dentist and has the following contact phone number (801) 472-0837.

The enumeration date for this NPI number is 8/26/2022 and was last updated on 8/8/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QD0000XClinic/CenterDentalNo
21223P0221XDentistPediatric DentistryYes

What is NPI?

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This page was last updated on: 11/21/2025

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