Individual provider Active NPI

Matthew W Plummer Jr., DMD MPH

  • General Practice Dentistry
  • Houston, TX
National Provider Identifier
1396965612
Registry record updated Sep 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
10664 Issued in TX
Practice address
5009 Caroline St Ste 201
Houston, TX 77004-5750
Phone
(713) 757-1948
Fax
(713) 757-9835
NPI assigned
Apr 27, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2019

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 10664 TX Primary

Addresses

Primary practice location

5009 Caroline St Ste 201
Houston, TX 77004-5750

Mailing address

2101 Crawford St
Ste 302
Houston, TX 77002-8941
Phone (713) 757-1948

Other identifiers 2

IdentifierTypeStateIssuer
737261OtherUNITED CONCORDIA
82D111OtherBCBS

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
I20160217000112 TX Order and Referring Only - DentistPractitioner - Dentist 4486959244

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10664TXMDCorneal and Contact Management Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Matthew W Plummer Jr DMD MPH Daphne L Brooks Reed DMD Inc General Practice Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1177632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569456000000",
    "number": "1396965612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 CRAWFORD ST",
            "address_2": "STE 302",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770028941",
            "telephone_number": "713-757-1948",
            "fax_number": "713-757-9835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5009 CAROLINE ST STE 201",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770045750",
            "telephone_number": "713-757-1948",
            "fax_number": "713-757-9835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLUMMER",
        "first_name": "MATTHEW",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DMD MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-27",
        "last_updated": "2019-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "10664",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "737261",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "82D111",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.