Individual provider Active NPI

Amar Trivedi, DDS

  • General Practice Dentistry
  • Baytown, TX
National Provider Identifier
1003104886
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
27219 Issued in TX
Practice address
8202 FM 3180 Rd
Baytown, TX 77523-1424
Phone
(281) 231-9630
NPI assigned
Jul 14, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 09184 IA
Dentist 122300000X 040428 PA
Pediatric Dentistry 1223P0221X LL900 MD
General Practice Dentistry 1223G0001X 27219 TX Primary

Addresses

Primary practice location

8202 FM 3180 Rd
Baytown, TX 77523-1424

Mailing address

2522 Shadow Oaks Dr
Fresno, TX 77545-6070
Phone (281) 515-6155

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200429000855 TX Practitioner - Dentist 6002246378 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
09184IAMDDentist
040428PAMDDentist
27219TXMDGeneral Practice Dentistry
LL900MDMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
TX Southern Dental PC Dentist CurrentSince Jul 13, 2025 Accepting new patients
Legacy Community Health Services, Inc Past Accepting new patients

Locations

8202 FM 3180 Rd
Baytown, TX 77523
Phone (281) 231-9630

Networks

  • TX HMO D-SNP
  • NM HMO C-SNP

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1310601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1003104886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2522 SHADOW OAKS DR",
            "city": "FRESNO",
            "state": "TX",
            "postal_code": "775456070",
            "telephone_number": "281-515-6155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8202 FM 3180 RD",
            "city": "BAYTOWN",
            "state": "TX",
            "postal_code": "775231424",
            "telephone_number": "281-231-9630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRIVEDI",
        "first_name": "AMAR",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-14",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IA",
            "license": "09184",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "040428",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MD",
            "license": "LL900",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "27219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baytown, TX

Sources for this page

Verify at the official NPI Registry.