Individual provider Active NPI

Sharon Minott-Warren, DDS

  • Periodontics
  • Pearland, TX
National Provider Identifier
1043437023
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
17294 Issued in TX
Practice address
10015 Broadway St Ste a
Pearland, TX 77584-7879
Phone
(713) 436-0211
NPI assigned
Apr 19, 2007
Sex
Female
Sole proprietor
No

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
Periodontics 1223P0300X 17294 TX Primary

Addresses

Primary practice location

10015 Broadway St Ste a
Pearland, TX 77584-7879

Mailing address

10015 Broadway, Ste a
Pearland, TX 77584
Phone (713) 436-0211

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
I20150724012349 TX Order and Referring Only - DentistPractitioner - Dentist 4688987241

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17294TXMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043437023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10015 BROADWAY, STE A",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "77584",
            "telephone_number": "713-436-0211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10015 BROADWAY ST STE A",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775847879",
            "telephone_number": "713-436-0211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINOTT-WARREN",
        "first_name": "SHARON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "TX",
            "license": "17294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pearland, TX

Sources for this page

Verify at the official NPI Registry.