Active NPI
Mark Anthony Diehl, D.D.S.
- General Practice Dentistry
- Houston, TX
National Provider Identifier
1447472121
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 21731
- Practice address
- 12727 Kimberley LN
Suite 201
Houston, TX 77024-4047 - Phone
- (713) 461-5961
- Fax
- (713) 461-9343
- NPI assigned
- May 3, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 21731 | TX | Primary |
Addresses
Primary practice location
12727 Kimberley LN
Suite 201
Houston, TX 77024-4047
Mailing address
12727 Kimberley LN
Suite 201
Houston, TX 77024-4047
Phone (713) 461-5961
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jan 1, 2016 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21731 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1447472121",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12727 KIMBERLEY LN",
"address_2": "SUITE 201",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770244047",
"telephone_number": "713-461-5961",
"fax_number": "713-461-9343"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12727 KIMBERLEY LN",
"address_2": "SUITE 201",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770244047",
"telephone_number": "713-461-5961",
"fax_number": "713-461-9343"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIEHL",
"first_name": "MARK",
"middle_name": "ANTHONY",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "21731",
"primary": true
}
],
"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 Jul 8, 2007; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.