Individual provider Active NPI

Michael J Landry, DDS

  • General Practice Dentistry
  • Spring, TX
National Provider Identifier
1215948369
Registry record updated Feb 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12854 Issued in TX
Practice address
9700 Louetta Road
Spring, TX 77379-3195
Phone
(281) 370-8786
Fax
(281) 894-4785
NPI assigned
Aug 11, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2021

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 12854 TX Primary

Addresses

Primary practice location

9700 Louetta Road
Spring, TX 77379-3195

Mailing address

9700 Louetta Road
Spring, TX 77379-3195
Phone (281) 370-8786

Other identifiers 1

IdentifierTypeStateIssuer
D12854OtherTXBLUE CROSS BLUE SHIELD

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
12854TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Houston Sleep Apnea, PLLC General Practice CurrentSince May 4, 2019 Accepting new patients
Premier Dental Club PC General Practice PastSince Jul 17, 2022 Accepting new patients

Locations

9720 Cypresswood Dr
Ste 200
Houston, TX 77070
Phone (281) 370-8786

9700 Louetta Rd
Spring, TX 77379
Phone (281) 370-8786

Organizations & group practices 2

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": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612396800000",
    "number": "1215948369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9700 LOUETTA ROAD",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773793195",
            "telephone_number": "281-370-8786",
            "fax_number": "281-894-4785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9700 LOUETTA ROAD",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773793195",
            "telephone_number": "281-370-8786",
            "fax_number": "281-894-4785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDRY",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2021-02-04",
        "certification_date": "2021-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "12854",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "D12854",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 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.