Individual provider Active NPI

Alan Ramon Simmons, D.D.S

  • Dentist
  • Houston, TX
National Provider Identifier
1326148636
Registry record updated Nov 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
19218 Issued in TX
Practice address
277 W Gray St
Houston, TX 77019-5419
Phone
(713) 529-3597
Fax
(713) 529-9169
NPI assigned
Sep 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 19218TT TX
General Practice Dentistry 1223G0001X 19218 TX
Dentist 122300000X 19218 TX Primary

Addresses

Primary practice location

277 W Gray St
Houston, TX 77019-5419

Mailing address

277 W Gray St
Houston, TX 77019-5419
Phone (713) 529-3597

Other identifiers 1

IdentifierTypeStateIssuer
007937801MedicaidTX

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
I20170929000689 TX Order and Referring Only - DentistPractitioner - Dentist 8325313463

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19218TTTXMDEndodontist
19218TXMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574380800000",
    "number": "1326148636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "277 W GRAY ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770195419",
            "telephone_number": "713-529-3597",
            "fax_number": "713-529-9169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "277 W GRAY ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770195419",
            "telephone_number": "713-529-3597",
            "fax_number": "713-529-9169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "ALAN",
        "middle_name": "RAMON",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2019-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "TX",
            "license": "19218TT",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "19218",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "19218",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007937801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.