Active NPI
Gissela Bernal Anderson, DDS, MS
- Periodontics
- Houston, TX
National Provider Identifier
1275757486
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 17890
- Practice address
- 4142 Bellaire Blvd
Houston, TX 77025-1008 - Phone
- (713) 500-4385
- Fax
- (281) 265-0502
- NPI assigned
- Apr 12, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 17890 | TX | Primary |
| Periodontics | 1223P0300X | DE00008259 | WA |
Addresses
Primary practice location
4142 Bellaire Blvd
Houston, TX 77025-1008
Mailing address
22 Penny Green St
Sugar Land, TX 77479-2931
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A0070829 | Other | TX | DPS CONTROLLED SUBS. |
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17890 | TX | MD | Professional Counselor |
| DE00008259 | WA | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1275757486",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22 PENNY GREEN ST",
"city": "SUGAR LAND",
"state": "TX",
"postal_code": "774792931"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4142 BELLAIRE BLVD",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770251008",
"telephone_number": "713-500-4385",
"fax_number": "281-265-0502"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "GISSELA",
"middle_name": "BERNAL",
"name_prefix": "Dr.",
"credential": "DDS, MS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-12",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "TX",
"license": "17890",
"primary": true
},
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "WA",
"license": "DE00008259",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DPS CONTROLLED SUBS.",
"identifier": "A0070829",
"state": "TX"
}
],
"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 Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.