Individual provider Active NPI

John Sunnucks, D.D.S.

  • General Practice Dentistry
  • Howe, TX
National Provider Identifier
1174734941
Registry record updated Sep 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
19815 Issued in TX
Practice address
100 S Collins Fwy
Howe, TX 75459-4589
Phone
(903) 532-5545
NPI assigned
May 24, 2007
Last updated
Sep 3, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 19815 TX Primary

Addresses

Primary practice location

100 S Collins Fwy
Howe, TX 75459-4589

Mailing address

100 S Collins Fwy
Howe, TX 75459-4589
Phone (903) 532-5545

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150529001047 TX Order and Referring Only - General PracticePractitioner - General Practice 4284954454

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19815TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Health Associates of Texas, PC. General Practice 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662163200000",
    "number": "1174734941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 S COLLINS FWY",
            "city": "HOWE",
            "state": "TX",
            "postal_code": "754594589",
            "telephone_number": "903-532-5545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S COLLINS FWY",
            "city": "HOWE",
            "state": "TX",
            "postal_code": "754594589",
            "telephone_number": "903-532-5545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUNNUCKS",
        "first_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-24",
        "last_updated": "2022-09-03",
        "certification_date": "2022-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "19815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Howe, TX

Sources for this page

Verify at the official NPI Registry.