Active NPI
De Shaunda Tamita Graves, D.D.S.
- General Practice Dentistry
- Houston, TX
National Provider Identifier
1093817710
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 19483
- Practice address
- 9413 Glenfield CT
Houston, TX 77096-3817 - Phone
- (713) 283-5210
- Fax
- (713) 283-5488
- NPI assigned
- Sep 2, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 19483 | TX | Primary |
Addresses
Primary practice location
9413 Glenfield CT
Houston, TX 77096-3817
Mailing address
9413 Glenfield CT
Houston, TX 77096-3817
Phone (713) 283-5210
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0095630-001 | Medicaid | TX |
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 |
|---|---|---|---|
| 19483 | TX | MD | General Practice Dentistry |
Interoperability endpoints
- dgraves91872@memorialhermann.direct-ci.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157155200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1093817710",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9413 GLENFIELD CT",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770963817",
"telephone_number": "713-283-5210",
"fax_number": "713-283-5488"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9413 GLENFIELD CT",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770963817",
"telephone_number": "713-283-5210",
"fax_number": "713-283-5488"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAVES",
"first_name": "DE SHAUNDA",
"middle_name": "TAMITA",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-09-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "19483",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0095630-001",
"state": "TX"
}
],
"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.