Individual provider Active NPI

Jeremy Jason Vela, DDS

  • Dentist
  • Houston, TX
National Provider Identifier
1386205136
Registry record updated Dec 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
35209 Issued in TX
Practice address
8800 Katy Fwy Ste 280
Houston, TX 77024-1645
Phone
(133) 659-9047
Fax
(713) 365-9856
NPI assigned
Jun 24, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 35209 TX
Dentist 122300000X 35209 TX Primary

Addresses

Primary practice location

8800 Katy Fwy Ste 280
Houston, TX 77024-1645

Mailing address

8800 Katy Fwy Ste 280
Houston, TX 77024-1645
Phone (713) 365-9904

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
I20241029004055 TX Practitioner - Dentist 1951834936

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
35209TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Loftin Dental, PLLC General Practice CurrentSince Oct 1, 2018 Accepting new patients
Epic Dental Associates Dentist PastSince Sep 18, 2024 Accepting new patients

Locations

1165 E Main St
Ste A
Alice, TX 78332
Phone (361) 664-8352

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1561334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1386205136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8800 KATY FWY STE 280",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770241645",
            "telephone_number": "713-365-9904",
            "fax_number": "713-365-9856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8800 KATY FWY STE 280",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770241645",
            "telephone_number": "133-659-9047",
            "fax_number": "713-365-9856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELA",
        "first_name": "JEREMY",
        "middle_name": "JASON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-24",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "35209",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "35209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.