Individual provider Active NPI

Nnamdi Lawrence Anosike, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Missouri City, TX
National Provider Identifier
1073006433
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
38284 Issued in TX
Practice address
2402 Wooded Park Dr
Missouri City, TX 77459-1537
Phone
(862) 202-0460
NPI assigned
Jun 11, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 38284 TX Primary

Addresses

Primary practice location

2402 Wooded Park Dr
Missouri City, TX 77459-1537

Mailing address

PO Box 1397
Missouri City, TX 77459-1397
Phone (862) 202-0460

Other practice location 1

215 S Loop 336 W Ste 100
Conroe, TX 77304-3362
Phone (936) 270-1294

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
I20240508002536 TX Practitioner - Oral Surgery 6800237827

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38284TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Platinum Touch Oral and Facial Surgery Oral and Maxillofacial Surgery CurrentSince Feb 9, 2025 Accepting new patients
Smiles by Spates, LLC PastSince Dec 3, 2023 Accepting new patients

Locations

9029 Highway 6
Ste 100
Missouri City, TX 77459
Phone (832) 847-1588

Organizations & group practices 2

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": "1528675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1073006433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1397",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "774591397",
            "telephone_number": "862-202-0460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2402 WOODED PARK DR",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "774591537",
            "telephone_number": "862-202-0460"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "215 S Loop 336 W Ste 100",
            "address_purpose": "LOCATION",
            "city": "Conroe",
            "state": "TX",
            "postal_code": "773043362",
            "country_code": "US",
            "telephone_number": "936-270-1294",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANOSIKE",
        "first_name": "NNAMDI",
        "middle_name": "LAWRENCE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-11",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "38284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missouri City, TX

Sources for this page

Verify at the official NPI Registry.