Individual provider Active NPI

George Dale Dodd, DDS

  • General Practice Dentistry
  • Pasadena, TX
National Provider Identifier
1396771200
Registry record updated Jun 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
13539 Issued in TX
Practice address
4121 Fairmont Pkwy
Pasadena, TX 77504-3301
Phone
(281) 506-7800
Fax
(281) 506-7805
NPI assigned
Jun 23, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 13539 TX Primary

Addresses

Primary practice location

4121 Fairmont Pkwy
Pasadena, TX 77504-3301

Mailing address

4121 Fairmont Pkwy
Pasadena, TX 77504-3301
Phone (281) 506-7800

Other identifiers 1

IdentifierTypeStateIssuer
009569701MedicaidTX

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
13539TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Chews to Smile Dental Group PLLC Past Accepting new patients
Rena Dental PC General Practice PastSince Jun 16, 2024 Accepting new patients

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": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435363200000",
    "number": "1396771200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4121 FAIRMONT PKWY",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775043301",
            "telephone_number": "281-506-7800",
            "fax_number": "281-506-7805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4121 FAIRMONT PKWY",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775043301",
            "telephone_number": "281-506-7800",
            "fax_number": "281-506-7805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DODD",
        "first_name": "GEORGE",
        "middle_name": "DALE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2015-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "13539",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009569701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2015; 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.