Individual provider Active NPI

Prerna Mathur

  • Dentist
  • Houston, TX
National Provider Identifier
1619383098
Registry record updated Jul 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
30157 Issued in TX
Practice address
7009 Almeda Rd
Apt #1215
Houston, TX 77054-2175
Phone
(405) 905-1370
NPI assigned
Jul 7, 2014
Last updated
Jul 7, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 30157 TX Primary

Addresses

Primary practice location

7009 Almeda Rd
Apt #1215
Houston, TX 77054-2175

Mailing address

7009 Almeda Rd
Apt #1215
Houston, TX 77054-2175
Phone (405) 905-1370

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
I20171026000481 TX Order and Referring Only - DentistPractitioner - Dentist 1456627025

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30157TXMDSchool Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1404691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404691200000",
    "number": "1619383098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7009 ALMEDA RD",
            "address_2": "APT #1215",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770542175",
            "telephone_number": "405-905-1370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7009 ALMEDA RD",
            "address_2": "APT #1215",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770542175",
            "telephone_number": "405-905-1370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHUR",
        "first_name": "PRERNA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-07",
        "last_updated": "2014-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "30157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.