Individual provider Active NPI

Maria Jezrell Santos, DDS

  • General Practice Dentistry
  • Kingwood, TX
National Provider Identifier
1124595517
Registry record updated Nov 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
34680 Issued in TX
Practice address
4582 Kingwood Dr Ste F
Kingwood, TX 77345-2639
Phone
(281) 746-9400
Fax
(281) 746-9400
NPI assigned
Oct 24, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 7148 NV
General Practice Dentistry 1223G0001X 103334 CA
General Practice Dentistry 1223G0001X 34680 TX Primary

Addresses

Primary practice location

4582 Kingwood Dr Ste F
Kingwood, TX 77345-2639

Mailing address

4582 Kingwood Dr Ste F
Kingwood, TX 77345-2639
Phone (281) 746-9400

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
103334CAMDGeneral Practice Dentistry
7148NVMDGeneral Practice Dentistry
34680TXMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1540339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636675200000",
    "number": "1124595517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4582 KINGWOOD DR STE F",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "773452639",
            "telephone_number": "281-746-9400",
            "fax_number": "281-746-9400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4582 KINGWOOD DR STE F",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "773452639",
            "telephone_number": "281-746-9400",
            "fax_number": "281-746-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTOS",
        "first_name": "MARIA JEZRELL",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-24",
        "last_updated": "2021-11-12",
        "certification_date": "2021-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "7148",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "103334",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "34680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingwood, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2021; 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.