Active NPI
Michael S Dwyer, B.A D.D.S M.S
- Periodontics
- The Woodlands, TX
National Provider Identifier
1518060722
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- D11072
- Practice address
- 1001 Medical Plaza Dr
Ste 110
The Woodlands, TX 77380-3241 - Phone
- (281) 363-2009
- NPI assigned
- Sep 6, 2006
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| Periodontics | 1223P0300X | D11072 | TX | Primary |
Addresses
Primary practice location
1001 Medical Plaza Dr
Ste 110
The Woodlands, TX 77380-3241
Mailing address
1001 Medical Plaza Dr
Ste 110
The Woodlands, TX 77380-3241
Phone (281) 363-2009
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 118721 | Other | TX | UNITED CONCORDIA |
| 81D741 | Other | TX | BLUECROSSBLUESHIELD |
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
- Credentials
- Bachelor of Arts, Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11072 | TX | MD | Chiropractor |
| D11072 | TX | MD | Periodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Montgomery County Periodontal Associates PC | Periodontics | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Periodontics
- The Woodlands, TX
- NPI 1528404894
-
- Periodontics
- Conroe, TX
- NPI 1962848226
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1518060722",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1001 MEDICAL PLAZA DR",
"address_2": "STE 110",
"city": "THE WOODLANDS",
"state": "TX",
"postal_code": "773803241",
"telephone_number": "281-363-2009",
"fax_number": "281-367-5622"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 MEDICAL PLAZA DR",
"address_2": "STE 110",
"city": "THE WOODLANDS",
"state": "TX",
"postal_code": "773803241",
"telephone_number": "281-363-2009"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DWYER",
"first_name": "MICHAEL",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "B.A D.D.S M.S",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "TX",
"license": "D11072",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA",
"identifier": "118721",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSSBLUESHIELD",
"identifier": "81D741",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in The Woodlands, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.