Individual provider Active NPI

Larry John Radney, DDS MSD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Webster, TX
National Provider Identifier
1104011725
Registry record updated Sep 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
10346 Issued in TX
Practice address
17201 Glenmount Park Dr
Webster, TX 77598-4300
Phone
(281) 486-5081
Fax
(281) 486-6507
NPI assigned
Sep 6, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 6, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 10346 TX Primary

Addresses

Primary practice location

17201 Glenmount Park Dr
Webster, TX 77598-4300

Mailing address

17201 Glenmount Park Dr
Webster, TX 77598-4300
Phone (281) 486-5081

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

LicenseStateTypeSpecialty
10346TXMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Meredith R Scott DDS MSD PA Orthodontics and Dentofacial Orthopedics 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": "1189036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189036800000",
    "number": "1104011725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17201 GLENMOUNT PARK DR",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775984300",
            "telephone_number": "281-486-5081",
            "fax_number": "281-486-6507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17201 GLENMOUNT PARK DR",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775984300",
            "telephone_number": "281-486-5081",
            "fax_number": "281-486-6507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADNEY",
        "first_name": "LARRY",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DDS MSD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-06",
        "last_updated": "2007-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "TX",
            "license": "10346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Webster, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 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.

Verify at the official NPI Registry.