Individual provider Active NPI

Adriana Michelle Maldonado Perez

  • General Practice Dentistry
  • The Woodlands, TX
National Provider Identifier
1619460045
Registry record updated Jun 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
33721 Issued in TX
Practice address
3115 College Park Dr Ste 105
The Woodlands, TX 77384-4001
Phone
(936) 321-8888
NPI assigned
Jun 11, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2018

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 33721 TX Primary

Addresses

Primary practice location

3115 College Park Dr Ste 105
The Woodlands, TX 77384-4001

Mailing address

2900 N Braeswood Blvd Apt 4118
Houston, TX 77025-2362
Phone (787) 643-6018

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
33721TXMDGeneral Practice Dentistry

Networks

  • Freedom Health HMO Network

NPI Registry JSON

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

{
    "created_epoch": "1528675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528675200000",
    "number": "1619460045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 N BRAESWOOD BLVD APT 4118",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770252362",
            "telephone_number": "787-643-6018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3115 COLLEGE PARK DR STE 105",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773844001",
            "telephone_number": "936-321-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALDONADO PEREZ",
        "first_name": "ADRIANA",
        "middle_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-11",
        "last_updated": "2018-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "33721",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jun 11, 2018; 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.