Active NPI
Maria Jezrell Santos, DDS
- General Practice Dentistry
- Kingwood, TX
National Provider Identifier
1124595517
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 34680
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 103334 | CA | MD | General Practice Dentistry |
| 7148 | NV | MD | General Practice Dentistry |
| 34680 | TX | MD | General 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.