Individual provider Active NPI

Maroun Fernand Dagher, DDS, CAGS, MSD

  • Periodontics
  • San Antonio, TX
National Provider Identifier
1508589961
Registry record updated Sep 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
38944 Issued in TX
Practice address
7703 Floyd Curl Dr # Mc7894
San Antonio, TX 78229-3901
Phone
(210) 567-3601
NPI assigned
Sep 21, 2022
Last updated
Sep 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 38944 TX Primary

Addresses

Primary practice location

7703 Floyd Curl Dr # Mc7894
San Antonio, TX 78229-3901

Mailing address

7703 Floyd Curl Dr # Mc7894
San Antonio, TX 78229-3901
Phone (210) 567-3601

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
I20230504001834 TX Order and Referring Only - DentistPractitioner - Dentist 8527423037

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38944TXMDSpeech-Language Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1663718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663718400000",
    "number": "1508589961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7703 FLOYD CURL DR # MC7894",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293901",
            "telephone_number": "210-567-3601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7703 FLOYD CURL DR # MC7894",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293901",
            "telephone_number": "210-567-3601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAGHER",
        "first_name": "MAROUN",
        "middle_name": "FERNAND",
        "name_prefix": "Dr.",
        "credential": "DDS, CAGS, MSD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-09-21",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "TX",
            "license": "38944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.