Active NPI
Lisa Catherine Selem, D.D.S.
- Endodontics
- Houston, TX
National Provider Identifier
1033498738
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 31304
- Practice address
- 19235 Katy Fwy
Suite 300B
Houston, TX 77094-1036 - Phone
- (281) 647-6687
- NPI assigned
- Aug 11, 2011
- Last updated
- Feb 29, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 31304 | TX | Primary |
| General Practice Dentistry | 1223G0001X | DN014283 | GA |
Addresses
Primary practice location
19235 Katy Fwy
Suite 300B
Houston, TX 77094-1036
Mailing address
19235 Katy Fwy
Ste 300B
Houston, TX 77094-1038
Phone (281) 647-6687
Other names 1
- Miss Lisa Catherine Jordan
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31304 | TX | MD | Endodontist |
| DN014283 | GA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1313020800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1456704000000",
"number": "1033498738",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19235 KATY FWY",
"address_2": "STE 300B",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770941038",
"telephone_number": "281-647-6687"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19235 KATY FWY",
"address_2": "SUITE 300B",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770941036",
"telephone_number": "281-647-6687"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SELEM",
"first_name": "LISA",
"middle_name": "CATHERINE",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-08-11",
"last_updated": "2016-02-29",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "TX",
"license": "31304",
"primary": true
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "GA",
"license": "DN014283",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "LISA",
"last_name": "JORDAN",
"middle_name": "CATHERINE",
"prefix": "MISS",
"code": "1",
"type": "Former Name"
}
]
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.