Individual provider Active NPI

Edgar Mafla, DDS

  • Dentist
  • Humble, TX
National Provider Identifier
1295964989
Registry record updated May 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
24793 Issued in TX
Practice address
8303 N Sam Houston Pkwy E Ste C
Humble, TX 77396-4933
Phone
(346) 616-5350
Fax
(346) 616-5353
NPI assigned
Jul 2, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 24793 TX Primary

Addresses

Primary practice location

8303 N Sam Houston Pkwy E Ste C
Humble, TX 77396-4933

Mailing address

8303 N Sam Houston Pkwy E Ste C
Humble, TX 77396-4933
Phone (346) 616-5350

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
I20250521003849 TX Practitioner - Dentist 8426432428 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
Other, 1993
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

8303 N Sam Houston Pkwy E
Suite C
Humble, TX 77396-4933
Phone (346) 457-0613

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
24793TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Optimal Sleep Solutions PLLC Dentist CurrentSince Jun 22, 2022 Accepting new patients
Innovative Dentistry of Fall Creek, PLLC General Practice CurrentSince Jul 24, 2022 Accepting new patients

Locations

8303 N Sam Houston Pkwy E
Ste C
Humble, TX 77396
Phone (346) 457-0613

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.

NPI Registry JSON

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

{
    "created_epoch": "1246492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747180800000",
    "number": "1295964989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8303 N SAM HOUSTON PKWY E STE C",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773964933",
            "telephone_number": "346-616-5350",
            "fax_number": "346-616-5353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8303 N SAM HOUSTON PKWY E STE C",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773964933",
            "telephone_number": "346-616-5350",
            "fax_number": "346-616-5353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAFLA",
        "first_name": "EDGAR",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-02",
        "last_updated": "2025-05-14",
        "certification_date": "2025-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "24793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Humble, TX

Sources for this page

Verify at the official NPI Registry.