Active NPI
Sam Robert Adkisson, D.D.S.
- Prosthodontics
- Houston, TX
National Provider Identifier
1316064884
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- F21812
- Practice address
- University of Texas Dental Branch
6516 MD Anderson Blvd.
Houston, TX 77030-3402 - Phone
- (713) 500-4140
- Fax
- (713) 500-4353
- NPI assigned
- Mar 22, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | F21812 | TX | Primary |
Addresses
Primary practice location
University of Texas Dental Branch
6516 MD Anderson Blvd.
Houston, TX 77030-3402
Mailing address
2811 Bermuda Dunes Dr
Missouri City, TX 77459-2425
Phone (713) 500-4140
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 |
|---|---|---|---|
| F21812 | TX | MD | Prosthodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1316064884",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2811 BERMUDA DUNES DR",
"city": "MISSOURI CITY",
"state": "TX",
"postal_code": "774592425",
"telephone_number": "713-500-4140",
"fax_number": "713-500-4353"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "UNIVERSITY OF TEXAS DENTAL BRANCH",
"address_2": "6516 MD ANDERSON BLVD.",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770303402",
"telephone_number": "713-500-4140",
"fax_number": "713-500-4353"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ADKISSON",
"first_name": "SAM",
"middle_name": "ROBERT",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "TX",
"license": "F21812",
"primary": true
}
],
"identifiers": [],
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.