Individual provider Active NPI

Peter Nguyen Van Tho, DDS

  • General Practice Dentistry
  • Houston, TX
National Provider Identifier
1295802734
Registry record updated Feb 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
17169 Issued in TX
Practice address
12002 Veterans Memorial Drive
Suite B3
Houston, TX 77067
Phone
(281) 580-7446
Fax
(281) 580-7520
NPI assigned
Nov 29, 2006
Last updated
Feb 14, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2024

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 17169 TX Primary

Addresses

Primary practice location

12002 Veterans Memorial Drive
Suite B3
Houston, TX 77067

Mailing address

12002 Veterans Memorial Drive
Suite B3
Houston, TX 77067
Phone (281) 580-7446

Other practice location 1

11574 Bellaire Blvd
Houston, TX 77072-2448
Phone (281) 561-7800

Other identifiers 1

IdentifierTypeStateIssuer
090749501MedicaidTX

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
17169TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Van Tho Dental Center Past Accepting new patients
Van Tho Dental Center 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707868800000",
    "number": "1295802734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12002 VETERANS MEMORIAL DRIVE",
            "address_2": "SUITE B3",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77067",
            "telephone_number": "281-580-7446",
            "fax_number": "281-580-7520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12002 VETERANS MEMORIAL DRIVE",
            "address_2": "SUITE B3",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77067",
            "telephone_number": "281-580-7446",
            "fax_number": "281-580-7520"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11574 Bellaire Blvd",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770722448",
            "country_code": "US",
            "telephone_number": "281-561-7800",
            "fax_number": "281-561-9978",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAN THO",
        "first_name": "PETER",
        "middle_name": "NGUYEN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2024-02-14",
        "certification_date": "2024-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "17169",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "090749501",
            "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 Feb 14, 2024; 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.