Active NPI
Jerry Lynn Neidlinger, DDS
- Prosthodontics
- Houston, TX
National Provider Identifier
1083724199
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 845
- Practice address
- 2002 Holcombe Blvd
Michael E. Debakey VA Medical Center
Houston, TX 77030 - Phone
- (713) 791-1414
- Fax
- (713) 794-7640
- NPI assigned
- Aug 30, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | 845 | HI | Primary |
Addresses
Primary practice location
2002 Holcombe Blvd
Michael E. Debakey VA Medical Center
Houston, TX 77030
Mailing address
2002 Holcombe Blvd
Michael E. Debakey VA Medical Center
Houston, TX 77030
Phone (713) 791-1414
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
| License | State | Type | Specialty |
|---|---|---|---|
| 845 | HI | MD | Prosthodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1083724199",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2002 HOLCOMBE BLVD",
"address_2": "MICHAEL E. DEBAKEY VA MEDICAL CENTER",
"city": "HOUSTON",
"state": "TX",
"postal_code": "77030",
"telephone_number": "713-791-1414",
"fax_number": "713-794-7640"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2002 HOLCOMBE BLVD",
"address_2": "MICHAEL E. DEBAKEY VA MEDICAL CENTER",
"city": "HOUSTON",
"state": "TX",
"postal_code": "77030",
"telephone_number": "713-791-1414",
"fax_number": "713-794-7640"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEIDLINGER",
"first_name": "JERRY",
"middle_name": "LYNN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "HI",
"license": "845",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.