Active NPI
Stephen A Sperry, D.D.S.
- Dentist
- Omaha, TX
National Provider Identifier
1427344712
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 26563
- Practice address
- 607 Ray Jacobs Ave
Omaha, TX 75571-4142 - Phone
- (903) 884-2321
- Fax
- (903) 884-3373
- NPI assigned
- Jun 24, 2011
- Last updated
- Jun 24, 2011
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 26563 | TX | Primary |
Addresses
Primary practice location
607 Ray Jacobs Ave
Omaha, TX 75571-4142
Mailing address
PO Box 1107
Omaha, TX 75571-1107
Phone (903) 884-2321
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26563 | TX | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shahid Dental Group, PLLC | 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, 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": "1308873600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308873600000",
"number": "1427344712",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1107",
"city": "OMAHA",
"state": "TX",
"postal_code": "755711107",
"telephone_number": "903-884-2321",
"fax_number": "903-884-3373"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "607 RAY JACOBS AVE",
"city": "OMAHA",
"state": "TX",
"postal_code": "755714142",
"telephone_number": "903-884-2321",
"fax_number": "903-884-3373"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPERRY",
"first_name": "STEPHEN",
"middle_name": "A",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-06-24",
"last_updated": "2011-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "26563",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Omaha, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.