Individual provider Active NPI

Pratik Manoj Vakil, D.M.D.

  • General Practice Dentistry
  • Houston, TX
National Provider Identifier
1023390879
Registry record updated Feb 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
29275 Issued in TX
Practice address
14637 Memorial Dr
Suite B
Houston, TX 77079-7519
Phone
(832) 259-4006
Fax
(281) 406-8167
NPI assigned
Sep 16, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 055823 NY
General Practice Dentistry 1223G0001X 29275 TX Primary

Addresses

Primary practice location

14637 Memorial Dr
Suite B
Houston, TX 77079-7519

Mailing address

14637 Memorial Dr
Suite B
Houston, TX 77079-7519
Phone (832) 259-4006

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
055823NYMDGeneral Practice Dentistry
29275TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Couture PLLC Past Accepting new patients
Legacy Community Health Services, Inc Past Accepting new patients

Organizations & group practices 2

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": "1316131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423612800000",
    "number": "1023390879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14637 MEMORIAL DR",
            "address_2": "SUITE B",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770797519",
            "telephone_number": "832-259-4006",
            "fax_number": "281-406-8167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14637 MEMORIAL DR",
            "address_2": "SUITE B",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770797519",
            "telephone_number": "832-259-4006",
            "fax_number": "281-406-8167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAKIL",
        "first_name": "PRATIK",
        "middle_name": "MANOJ",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-16",
        "last_updated": "2015-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "055823",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "29275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.