Individual provider Active NPI

Roberto Lozada, D.D.S

  • General Practice Dentistry
  • Houston, TX
National Provider Identifier
1396954962
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
22558 Issued in TX
Practice address
5990 Airline Dr
Suite 100
Houston, TX 77076-4233
Phone
(713) 697-2631
NPI assigned
May 21, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 54013 CA
General Practice Dentistry 1223G0001X 22558 TX Primary

Addresses

Primary practice location

5990 Airline Dr
Suite 100
Houston, TX 77076-4233

Mailing address

3676 Marlesta Dr
San Diego, CA 92111-4753
Phone (415) 309-4612

Other identifiers 1

IdentifierTypeStateIssuer
1776171-01MedicaidTX

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
22558TXMDGeneral Practice Dentistry
54013CAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
R Glenn Morris DDS Inc Past Accepting new patients
R. Glenn Morris DDS Past 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, 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": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396954962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3676 MARLESTA DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921114753",
            "telephone_number": "415-309-4612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5990 AIRLINE DR",
            "address_2": "SUITE 100",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770764233",
            "telephone_number": "713-697-2631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOZADA",
        "first_name": "ROBERTO",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "54013",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "22558",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1776171-01",
            "state": "TX"
        }
    ],
    "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 8, 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.

Verify at the official NPI Registry.