Individual provider Active NPI

Gregory S Poindexter, D.D.S.

  • Pediatric Dentistry
  • Houston, TX
National Provider Identifier
1417209446
Registry record updated Jun 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
29504 Issued in TX
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

Updated by the provider on Jun 27, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160127001497 TX Order and Referring Only - Other (Physician)Practitioner - 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

Verify at the official NPI Registry.