Active NPI
Maisa M Idriss, DMD
- Dentist
- Houston, TX
National Provider Identifier
1346430568
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 17900
- Practice address
- 16215 North Freeway
Ste 100
Houston, TX 77090 - Phone
- (281) 444-0030
- Fax
- (281) 440-5192
- NPI assigned
- Jul 25, 2007
- Last updated
- Jul 25, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 17900 | TX | Primary |
Addresses
Primary practice location
16215 North Freeway
Ste 100
Houston, TX 77090
Mailing address
16215 North Freeway
Ste 100
Houston, TX 77090
Phone (281) 444-0030
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 |
|---|---|---|---|
| 17900 | TX | MD | Speech-Language Pathologist |
Organizations & group practices 1
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": "1185321600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1185321600000",
"number": "1346430568",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16215 NORTH FREEWAY",
"address_2": "STE 100",
"city": "HOUSTON",
"state": "TX",
"postal_code": "77090",
"telephone_number": "281-444-0030",
"fax_number": "281-440-5192"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16215 NORTH FREEWAY",
"address_2": "STE 100",
"city": "HOUSTON",
"state": "TX",
"postal_code": "77090",
"telephone_number": "281-444-0030",
"fax_number": "281-440-5192"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IDRISS",
"first_name": "MAISA",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-07-25",
"last_updated": "2007-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "17900",
"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 25, 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.