Individual provider Active NPI

Vanessa Muniz, D.D.S

  • General Practice Dentistry
  • Conroe, TX
National Provider Identifier
1609321462
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
32235 Issued in TX
Practice address
605 S Conroe Medical Dr
Conroe, TX 77304-4722
Phone
(936) 539-4004
Fax
(936) 521-8450
NPI assigned
Aug 22, 2016
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 32235 TX Primary

Addresses

Primary practice location

605 S Conroe Medical Dr
Conroe, TX 77304-4722

Mailing address

605 S Conroe Medical Dr
Conroe, TX 77304-4722
Phone (936) 539-4004

Other identifiers 1

IdentifierTypeStateIssuer
3888570-01MedicaidTX

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
I20170404001242 TX Order and Referring Only - DentistPractitioner - Dentist 9133405269

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Woodlands Smiles Dentistry and Orthodontics, PC General Practice Past Accepting new patients
Lone Star Community Health Center, Inc. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: vanessa.muniz.1@31617.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1471824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1609321462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 S CONROE MEDICAL DR",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773044722",
            "telephone_number": "936-539-4004",
            "fax_number": "936-539-3635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 S CONROE MEDICAL DR",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773044722",
            "telephone_number": "936-539-4004",
            "fax_number": "936-521-8450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNIZ",
        "first_name": "VANESSA",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-22",
        "last_updated": "2023-03-07",
        "certification_date": "2021-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "32235",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3888570-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conroe, TX

Sources for this page

Verify at the official NPI Registry.