Individual provider Active NPI

Jesus Mario Velasquez, D.D.S.

  • Periodontics
  • Houston, TX
National Provider Identifier
1093803645
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
18000 Issued in TX
Practice address
9388 Richmond Ave
Houston, TX 77063-3947
Phone
(713) 785-3355
Fax
(713) 785-7007
NPI assigned
Oct 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 18000 TX
Periodontics 1223P0300X 18000 TX Primary

Addresses

Primary practice location

9388 Richmond Ave
Houston, TX 77063-3947

Mailing address

9388 Richmond Ave
Houston, TX 77063-3947
Phone (713) 785-3355

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 23, 2020 through Jan 23, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
18000TXMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
J. Mario Velasquez D.D.S. Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1093803645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9388 RICHMOND AVE",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770633947",
            "telephone_number": "713-785-3355",
            "fax_number": "713-785-7007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9388 RICHMOND AVE",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770633947",
            "telephone_number": "713-785-3355",
            "fax_number": "713-785-7007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELASQUEZ",
        "first_name": "JESUS",
        "middle_name": "MARIO",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "18000",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "TX",
            "license": "18000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.