Individual provider Active NPI

Michael Brian Eshelman, D.D.S.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Tomball, TX
National Provider Identifier
1376631986
Registry record updated Sep 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
13453 Issued in TX
Practice address
1017 W Main St
Tomball, TX 77375-5525
Phone
(281) 255-4647
Fax
(281) 255-4706
NPI assigned
Oct 10, 2006
Last updated
Sep 15, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 13453 TX Primary
General Practice Dentistry 1223G0001X 13453 TX

Addresses

Primary practice location

1017 W Main St
Tomball, TX 77375-5525

Mailing address

1017 W Main St
Tomball, TX 77375-5525
Phone (281) 255-4647

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
13453TXMDOrthodontics and Dentofacial Orthopedic Dentist

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473897600000",
    "number": "1376631986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1017 W MAIN ST",
            "city": "TOMBALL",
            "state": "TX",
            "postal_code": "773755525",
            "telephone_number": "281-255-4647",
            "fax_number": "281-255-4706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1017 W MAIN ST",
            "city": "TOMBALL",
            "state": "TX",
            "postal_code": "773755525",
            "telephone_number": "281-255-4647",
            "fax_number": "281-255-4706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESHELMAN",
        "first_name": "MICHAEL",
        "middle_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2016-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "TX",
            "license": "13453",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "13453",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tomball, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2016; 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.