Active NPI
Gregory S Poindexter, D.D.S.
- Pediatric Dentistry
- Houston, TX
National Provider Identifier
1417209446
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 29504
- Practice address
- 6102 Scott St Ste E
Houston, TX 77021 - Phone
- (281) 519-0725
- NPI assigned
- Oct 15, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 29504 | TX | Primary |
| General Practice Dentistry | 1223G0001X | 29504 | TX |
Addresses
Primary practice location
6102 Scott St Ste E
Houston, TX 77021
Mailing address
12016 Cedar Creek Dr
Pearland, TX 77584-1641
Phone (615) 403-7534
Other practice location 1
1005 D.B. Todd Blvd
Nashville, TN 37208-3599
Phone (615) 327-6297
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 |
|---|---|---|---|---|
| I20160127001497 | TX | Order and Referring Only - Other (Physician) | 5799088696 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1350259200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1561593600000",
"number": "1417209446",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12016 CEDAR CREEK DR",
"city": "PEARLAND",
"state": "TX",
"postal_code": "775841641",
"telephone_number": "615-403-7534"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6102 SCOTT ST STE E",
"city": "HOUSTON",
"state": "TX",
"postal_code": "77021",
"telephone_number": "281-519-0725"
}
],
"practiceLocations": [
{
"address_1": "1005 D.B. Todd Blvd",
"address_purpose": "LOCATION",
"city": "Nashville",
"state": "TN",
"postal_code": "372083599",
"country_code": "US",
"telephone_number": "615-327-6297",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "POINDEXTER",
"first_name": "GREGORY",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-10-15",
"last_updated": "2019-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "TX",
"license": "29504",
"primary": true
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "29504",
"primary": false
}
],
"identifiers": [],
"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 Jun 27, 2019; 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.