Provider Demographics
NPI:1346478195
Name:FERGUSON, REGINA LYNN (DDS)
Entity type:Individual
Prefix:DR
First Name:REGINA
Middle Name:LYNN
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6015 HILLCROFT ST
Mailing Address - Street 2:STE 1600
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77081-1019
Mailing Address - Country:US
Mailing Address - Phone:832-201-3655
Mailing Address - Fax:832-377-4499
Practice Address - Street 1:8143 LONG POINT RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-2032
Practice Address - Country:US
Practice Address - Phone:832-201-3655
Practice Address - Fax:832-377-4499
Is Sole Proprietor?:No
Enumeration Date:2009-06-30
Last Update Date:2010-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX259231223G0001X
TN90131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice