Individual provider Active NPI

Charles Steven Fortenberry, D.D.S.

  • General Practice Dentistry
  • Houston, TX
National Provider Identifier
1013923432
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
13614 Issued in TX
Practice address
7737 Southwest Fwy
Suite 960
Houston, TX 77074-1807
Phone
(713) 774-9774
Fax
(713) 771-8558
NPI assigned
Jul 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 13614 TX Primary

Addresses

Primary practice location

7737 Southwest Fwy
Suite 960
Houston, TX 77074-1807

Mailing address

7737 Southwest Fwy
Suite 960
Houston, TX 77074-1807
Phone (713) 774-9774

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
I20151230000734 TX Order and Referring Only - DentistPractitioner - Dentist 0042512568

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13614TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Steven Fortenberry DDS PLLC General Practice Past Accepting new patients

Organizations & group practices 1

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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013923432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7737 SOUTHWEST FWY",
            "address_2": "SUITE 960",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770741807",
            "telephone_number": "713-774-9774",
            "fax_number": "713-771-8558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7737 SOUTHWEST FWY",
            "address_2": "SUITE 960",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770741807",
            "telephone_number": "713-774-9774",
            "fax_number": "713-771-8558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTENBERRY",
        "first_name": "CHARLES",
        "middle_name": "STEVEN",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "13614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.