Active NPI
Mark A Pigno, D.D.S.
- Prosthodontics
- Beaumont, TX
National Provider Identifier
1407941065
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 18252
- Practice address
- 3510 Fannin Street
Beaumont, TX 77701 - Phone
- (409) 835-5300
- NPI assigned
- Oct 3, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | 18252 | TX | Primary |
| Prosthodontics | 1223P0700X | 4443 | LA | |
| Oral & Maxillofacial Surgery (D.M.D.) | 204E00000X | 18252 | TX |
Addresses
Primary practice location
3510 Fannin Street
Beaumont, TX 77701
Mailing address
4223 Hillbrook Drive
Orange, TX 77632
Phone (409) 835-5300
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1892955 | Medicaid | LA | |
| 130543507 | Medicaid | TX |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041130000453 | TX | Practitioner - Oral Surgery | 3971568171 | Practice locations: Beaumont, TX |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4443 | LA | MD | Mental Health Counselor |
| 18252 | TX | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1252800000000",
"number": "1407941065",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4223 HILLBROOK DRIVE",
"city": "ORANGE",
"state": "TX",
"postal_code": "77632",
"telephone_number": "409-835-5300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3510 FANNIN STREET",
"city": "BEAUMONT",
"state": "TX",
"postal_code": "77701",
"telephone_number": "409-835-5300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PIGNO",
"first_name": "MARK",
"middle_name": "A",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-03",
"last_updated": "2009-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "TX",
"license": "18252",
"primary": true
},
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "LA",
"license": "4443",
"primary": false
},
{
"code": "204E00000X",
"taxonomy_group": "",
"desc": "Oral & Maxillofacial Surgery",
"state": "TX",
"license": "18252",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1892955",
"state": "LA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "130543507",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Beaumont, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.