Individual provider Active NPI

Steven Fossum, DDS

  • General Practice Dentistry
  • Harker Heights, TX
National Provider Identifier
1043398365
Registry record updated Feb 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
22804 Issued in TX
Practice address
201 E Cen Tex Expy
#500
Harker Heights, TX 76548-1887
Phone
(713) 443-0984
Fax
(254) 690-1506
NPI assigned
Nov 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2009

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 22804 TX Primary

Addresses

Primary practice location

201 E Cen Tex Expy
#500
Harker Heights, TX 76548-1887

Mailing address

201 E Cen Tex Expy
#500
Harker Heights, TX 76548-1887
Phone (713) 443-0984

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
22804TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Richmond Dental Care General Practice CurrentSince Oct 10, 2021 Accepting new patients

Locations

1840 FM 359 Rd
Richmond, TX 77406
Phone (832) 595-2266

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233619200000",
    "number": "1043398365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E CEN TEX EXPY",
            "address_2": "#500",
            "city": "HARKER HEIGHTS",
            "state": "TX",
            "postal_code": "765481887",
            "telephone_number": "713-443-0984",
            "fax_number": "254-690-1506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E CEN TEX EXPY",
            "address_2": "#500",
            "city": "HARKER HEIGHTS",
            "state": "TX",
            "postal_code": "765481887",
            "telephone_number": "713-443-0984",
            "fax_number": "254-690-1506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOSSUM",
        "first_name": "STEVEN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2009-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "22804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harker Heights, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.