Active NPI
Patrick M Ralph, DMD
- Pediatric Dentistry
- Houston, TX
National Provider Identifier
1285642017
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 20140
- Practice address
- 11921 Bissonnet St
Houston, TX 77099-1425 - Phone
- (281) 495-3343
- Fax
- (281) 495-1125
- NPI assigned
- Aug 4, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 20140 | TX | Primary |
Addresses
Primary practice location
11921 Bissonnet St
Houston, TX 77099-1425
Mailing address
11921 Bissonnet St
Houston, TX 77099-1425
Phone (281) 495-3343
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 169367301 | Medicaid | TX |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 20140 | TX | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Passionate Dental Wellness PA Corporation | Current | Accepting new patients | |
| Pediatric Dental Wellness | Pediatric Dentistry | Past | Accepting new patients |
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.
-
- Dental Clinic/Center
- Jasper, TX
- NPI 1932871100
-
- Pediatric Dentistry
- Houston, TX
- NPI 1386867752
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154649600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623024000000",
"number": "1285642017",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11921 BISSONNET ST",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770991425",
"telephone_number": "281-495-3343",
"fax_number": "281-495-1125"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11921 BISSONNET ST",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770991425",
"telephone_number": "281-495-3343",
"fax_number": "281-495-1125"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RALPH",
"first_name": "PATRICK",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-04",
"last_updated": "2021-06-07",
"certification_date": "2021-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "TX",
"license": "20140",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "169367301",
"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 Jun 7, 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.