Active NPI
Ian Anthony Sport, DDS
- Dentist
- Houston, TX
National Provider Identifier
1689058307
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 31190
- Practice address
- 6421 W 43Rd St
Houston, TX 77092-4005 - Phone
- (817) 217-5110
- NPI assigned
- Jul 13, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 31190 | TX | Primary |
Addresses
Primary practice location
6421 W 43Rd St
Houston, TX 77092-4005
Mailing address
155 Birdsall St
#406
Houston, TX 77007-2569
Phone (817) 217-5110
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
| License | State | Type | Specialty |
|---|---|---|---|
| 31190 | TX | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1436745600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1436745600000",
"number": "1689058307",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "155 BIRDSALL ST",
"address_2": "#406",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770072569",
"telephone_number": "817-217-5110"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6421 W 43RD ST",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770924005",
"telephone_number": "817-217-5110"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPORT",
"first_name": "IAN",
"middle_name": "ANTHONY",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-07-13",
"last_updated": "2015-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "31190",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
- Spoiled Unlimited LLC
- Susan Leah Sponenberg, MD
- Lauren Elizabeth Spoo, M.D.
- Aaron Joel Spooner, MD
- Joseph Douglas Spooner, PA-C
- Sports Medicine and Joint Preservation Center PLLC (Complete Orthopaedics)
- Spot ABA LLC
- Spot Dental, PLLC (Spot Dental)
- Spotlight Hospice Care LLC (Living Hope Hospice)
- Carissa L Spraberry, A.T.C., L.A.T., M.ED
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.