Serge Madhere, D.D.S

Primary specialty

DentistTaxonomy code 122300000X

License

33602 Issued in TX

Practice address

10177 W Grand Pkwy S Ste 103
Richmond, TX 77407-8643

Phone

(346) 702-3085

NPI assigned

Jul 16, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Dentists of Fort Bend, PC

  • Dentist
  • Richmond, TX
  • NPI 1659882611
  NPD (past)

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

{
    "created_epoch": "1184544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521763200000",
    "number": "1073712436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10177 W GRAND PKWY S STE 103",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774078643",
            "telephone_number": "346-702-3085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10177 W GRAND PKWY S STE 103",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774078643",
            "telephone_number": "346-702-3085"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3370 Baychester Ave",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104751565",
            "country_code": "US",
            "telephone_number": "718-671-2823",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MADHERE",
        "first_name": "SERGE",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-16",
        "last_updated": "2018-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "052905-1",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "33602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2018; 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.