Individual provider Active NPI

James Benjamin Quartey, DDS

  • General Practice Dentistry
  • Gonzales, TX
National Provider Identifier
1053322362
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
20139 Issued in TX
Practice address
228 Saint George St
Gonzales, TX 78629-3910
Phone
(830) 672-6511
Fax
(830) 672-6430
NPI assigned
Aug 11, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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 20139 TX Primary

Addresses

Primary practice location

228 Saint George St
Gonzales, TX 78629-3910

Mailing address

228 Saint George St
Gonzales, TX 78629-3910
Phone (830) 672-6511

Other identifiers 2

IdentifierTypeStateIssuer
20139OtherTXSTATE DENTAL LICENSE #
HO116178OtherTXDPS REG. #

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
I20201027001756 TX Practitioner - Dentist 8628101946

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20139TXMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1053322362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "228 SAINT GEORGE ST",
            "city": "GONZALES",
            "state": "TX",
            "postal_code": "786293910",
            "telephone_number": "830-672-6511",
            "fax_number": "830-672-6430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "228 SAINT GEORGE ST",
            "city": "GONZALES",
            "state": "TX",
            "postal_code": "786293910",
            "telephone_number": "830-672-6511",
            "fax_number": "830-672-6430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUARTEY",
        "first_name": "JAMES",
        "middle_name": "BENJAMIN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "20139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE DENTAL LICENSE #",
            "identifier": "20139",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DPS REG. #",
            "identifier": "HO116178",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gonzales, TX

Sources for this page

Verify at the official NPI Registry.