Individual provider Active NPI

Eduard Vernovsky, DDS

  • General Practice Dentistry
  • Houston, TX
National Provider Identifier
1245229939
Registry record updated Dec 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
27349 Issued in TX
Practice address
8200 Wednesbury LN
310
Houston, TX 77074-2925
Phone
(281) 501-0898
Fax
(281) 501-0898
NPI assigned
Oct 17, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019023309 IL
General Practice Dentistry 1223G0001X 27349 TX Primary

Addresses

Primary practice location

8200 Wednesbury LN
310
Houston, TX 77074-2925

Mailing address

8200 Wednesbury LN
310
Houston, TX 77074-2925
Phone (281) 501-0898

Other identifiers 1

IdentifierTypeStateIssuer
1004089MedicaidIL

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

LicenseStateTypeSpecialty
019023309ILMDGeneral Practice Dentistry
27349TXMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1129507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323043200000",
    "number": "1245229939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8200 WEDNESBURY LN",
            "address_2": "310",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770742925",
            "telephone_number": "281-501-0898",
            "fax_number": "281-501-0898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8200 WEDNESBURY LN",
            "address_2": "310",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770742925",
            "telephone_number": "281-501-0898",
            "fax_number": "281-501-0898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERNOVSKY",
        "first_name": "EDUARD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-17",
        "last_updated": "2011-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019023309",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "27349",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1004089",
            "state": "IL"
        }
    ],
    "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 Dec 5, 2011; 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.