Nagy B Ghattas, D.D.S

Key facts

NPI

1376767004

Entity type

Individual (NPI type 1)

Primary specialty

General Practice Dentistry 1223G0001X

License

18028 (TX)

Practice address

3403 Rivers Edge TRL
Kingwood, TX 77339-2634

Phone

(281) 973-5012

NPI assigned

Apr 12, 2007

Sex

Male

Sole proprietor

Yes

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 and National Provider Directory roles.

• Community Health Development Inc. Federally Qualified Health Center (FQHC) · Uvalde, TX · NPI 1134102403
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 24, 2022.

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645660800000",
    "number": "1376767004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13830 WINDWARD HARBOR CT",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770595013",
            "telephone_number": "713-440-8488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3403 RIVERS EDGE TRL",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "773392634",
            "telephone_number": "281-973-5012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHATTAS",
        "first_name": "NAGY",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-12",
        "last_updated": "2022-02-24",
        "certification_date": "2022-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "18028",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "18028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Kingwood, TX · General Practice Dentistry in Texas