Active NPI
Shawn Michael Rodgers, DDS
- Dentist
- Houston, TX
National Provider Identifier
1225298037
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 0024061
- Practice address
- 500 Dallas St
Ste. P70
Houston, TX 77002-4800 - Phone
- (866) 543-1909
- NPI assigned
- Jun 15, 2008
- Last updated
- Jun 17, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 0024061 | TX | Primary |
Addresses
Primary practice location
500 Dallas St
Ste. P70
Houston, TX 77002-4800
Mailing address
500 Dallas St
Ste. P70
Houston, TX 77002-4800
Phone (866) 543-1909
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: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160111000241 | TX | Order and Referring Only - Dentist | 1355643263 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0024061 | TX | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213488000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1213660800000",
"number": "1225298037",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 DALLAS ST",
"address_2": "STE. P70",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770024800",
"telephone_number": "866-543-1909"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 DALLAS ST",
"address_2": "STE. P70",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770024800",
"telephone_number": "866-543-1909"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODGERS",
"first_name": "SHAWN",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-06-15",
"last_updated": "2008-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "0024061",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.