Individual provider Active NPI

Kristiana Marie Tenorio, DDS

  • General Practice Dentistry
  • Houston, TX
National Provider Identifier
1225601735
Registry record updated May 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
37612 Issued in TX
Practice address
4004 S Braeswood Blvd Ste 300
Houston, TX 77025-3304
Phone
(346) 509-9099
NPI assigned
Jul 22, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2023

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 37612 TX Primary

Addresses

Primary practice location

4004 S Braeswood Blvd Ste 300
Houston, TX 77025-3304

Mailing address

4004 S Braeswood Blvd Ste 300
Houston, TX 77025-3304

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211020001009 TX Order and Referring Only - DentistPractitioner - Dentist 4587052766

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
37612TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
The Heights Modern Dentistry, PC General Practice PastSince Jul 1, 2021 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1626912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682985600000",
    "number": "1225601735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4004 S BRAESWOOD BLVD STE 300",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770253304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4004 S BRAESWOOD BLVD STE 300",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770253304",
            "telephone_number": "346-509-9099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TENORIO",
        "first_name": "KRISTIANA",
        "middle_name": "MARIE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-22",
        "last_updated": "2023-05-02",
        "certification_date": "2023-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "37612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.