Karderro Dixon, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

35869 Issued in TX

Practice address

25653 Highway 59 N Ste 207
Kingwood, TX 77339-1797

Phone

(832) 463-4411

NPI assigned

Mar 21, 2019

Last updated

Dec 15, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1553126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671062400000",
    "number": "1033679485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25653 HIGHWAY 59 N STE 207",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "773391797",
            "telephone_number": "985-856-9279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25653 HIGHWAY 59 N STE 207",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "773391797",
            "telephone_number": "832-463-4411"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3301 Veterans Blvd Suite 203",
            "address_purpose": "LOCATION",
            "city": "Metairie",
            "state": "LA",
            "postal_code": "70002",
            "country_code": "US",
            "telephone_number": "504-833-6825",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIXON",
        "first_name": "KARDERRO",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-21",
        "last_updated": "2022-12-15",
        "certification_date": "2022-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "35869",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "7025",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Crysta Dillashaw, LCSW
• Craig Ditommaso, MD
• Adam Joseph Divincenzo, D.M.D.
• Dixon Home and Community Services LLC
• Ashley Elizabeth Dixon, LPC
• Martha S Dixon, PA
• Danny Doan, PTA
• Thao Mai Doan
• Moira Kathleen Dodge, BCBA
• Amanda Dodson-Mooring, DO

• Dentist in Kingwood, TX
• Providers in Kingwood, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.