Individual provider Active NPI

Sina Masoudi, DDS

  • Dentist
  • Houston, TX
National Provider Identifier
1619227089
Registry record updated Feb 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
28370 Issued in TX
Practice address
3500 Little York Rd
Suite a-1
Houston, TX 77093-3658
Phone
(713) 766-3352
NPI assigned
Sep 13, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 61850 CA
Dentist 122300000X 28370 TX Primary

Addresses

Primary practice location

3500 Little York Rd
Suite a-1
Houston, TX 77093-3658

Mailing address

3500 Little York Rd
Suite a-1
Houston, TX 77093-3658
Phone (713) 766-3352

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
I20160504000615 TX Order and Referring Only - DentistPractitioner - Dentist 0345549861

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
61850CAMDClinical Social Worker
28370TXMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Kempwood Dental, PLLC Dentist Current 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1347494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613088000000",
    "number": "1619227089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 LITTLE YORK RD",
            "address_2": "SUITE A-1",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770933658",
            "telephone_number": "713-766-3352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 LITTLE YORK RD",
            "address_2": "SUITE A-1",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770933658",
            "telephone_number": "713-766-3352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASOUDI",
        "first_name": "SINA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-09-13",
        "last_updated": "2021-02-12",
        "certification_date": "2021-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "61850",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "28370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.