Individual provider Active NPI

Kirolls Ibrahim

  • General Practice Dentistry
  • Cypress, TX
National Provider Identifier
1619418944
Registry record updated Jun 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
34242 Issued in TX
Practice address
27008 Northwest Fwy Ste 120
Cypress, TX 77433-7950
Phone
(713) 999-9022
NPI assigned
Mar 20, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Dentistry 1223G0001X 34242 TX Primary

Addresses

Primary practice location

27008 Northwest Fwy Ste 120
Cypress, TX 77433-7950

Mailing address

16210 Pinon Vista Dr
Houston, TX 77095-7196

Other practice location 1

609 Elm St
Waco, TX 76704-2516
Phone (254) 313-6900

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

State licenses

LicenseStateTypeSpecialty
34242TXMDCounseling Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Top Dentistry, PLLC Dba Celine Dental General Practice CurrentSince Jul 2, 2023 Accepting new patients

Locations

27008 Northwest Fwy
Ste 120
Cypress, TX 77433
Phone (713) 999-9022

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": "1489968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688083200000",
    "number": "1619418944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16210 PINON VISTA DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770957196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27008 NORTHWEST FWY STE 120",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774337950",
            "telephone_number": "713-999-9022"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "609 Elm St",
            "address_purpose": "LOCATION",
            "city": "Waco",
            "state": "TX",
            "postal_code": "767042516",
            "country_code": "US",
            "telephone_number": "254-313-6900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IBRAHIM",
        "first_name": "KIROLLS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-20",
        "last_updated": "2023-06-30",
        "certification_date": "2023-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "34242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cypress, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.