Individual provider Active NPI

Virginia Kayron Dube, DDS

  • Pediatric Dentistry
  • Houston, TX
National Provider Identifier
1669016820
Registry record updated Oct 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
012959 Issued in TX
Practice address
11455 Fallbrook Dr
Houston, TX 77065-4238
Phone
(281) 890-7475
NPI assigned
Oct 31, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 012959 TX Primary

Addresses

Primary practice location

11455 Fallbrook Dr
Houston, TX 77065-4238

Mailing address

2109 County Road 436
Dime Box, TX 77853-5263
Phone (713) 823-0361

Other practice location 1

2109 County Road 436
Dime Box, TX 77853-5263
Phone (713) 823-9361

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
012959TXMDPediatric Dentist

NPI Registry JSON

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

{
    "created_epoch": "1572480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572480000000",
    "number": "1669016820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2109 COUNTY ROAD 436",
            "city": "DIME BOX",
            "state": "TX",
            "postal_code": "778535263",
            "telephone_number": "713-823-0361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11455 FALLBROOK DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770654238",
            "telephone_number": "281-890-7475"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2109 County Road 436",
            "address_purpose": "LOCATION",
            "city": "Dime Box",
            "state": "TX",
            "postal_code": "778535263",
            "country_code": "US",
            "telephone_number": "713-823-9361",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUBE",
        "first_name": "VIRGINIA",
        "middle_name": "KAYRON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-31",
        "last_updated": "2019-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "012959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2019; 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.