Individual provider Active NPI

Kenpan Hu, D.M.D

  • General Practice Dentistry
  • Laredo, TX
National Provider Identifier
1417182924
Registry record updated Apr 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
27439 Issued in TX
Practice address
4817 San Dario Avenue
Laredo, TX 78401
Phone
(956) 728-7412
Fax
(956) 728-7682
NPI assigned
May 28, 2009
Last updated
Apr 18, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2012

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 DN1855119 MA
General Practice Dentistry 1223G0001X 27439 TX Primary

Addresses

Primary practice location

4817 San Dario Avenue
Laredo, TX 78401

Mailing address

4817 San Dario Avenue
Laredo, TX 78401
Phone (617) 319-7110

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
I20210420001392 TX Practitioner - Dentist 5092123661 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN1855119MAMDGeneral Practice Dentistry
27439TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
B Hou Dental PA CurrentSince Mar 1, 2021 Accepting new patients
Brigitte E. Robinson, D.D.S., P.C. Past Accepting new patients

Locations

2681 MacArthur Blvd
Ste 101
Lewisville, TX 75067
Phone (469) 649-1199

Organizations & group practices 5

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": "1243468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334707200000",
    "number": "1417182924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4817 SAN DARIO AVENUE",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "78401",
            "telephone_number": "617-319-7110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4817 SAN DARIO AVENUE",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "78401",
            "telephone_number": "956-728-7412",
            "fax_number": "956-728-7682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HU",
        "first_name": "KENPAN",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-05-28",
        "last_updated": "2012-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN1855119",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "27439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laredo, TX

Sources for this page

Verify at the official NPI Registry.