Individual provider Active NPI

Patrick V. Nicosia, DDS, MS

  • Periodontics
  • Houston, TX
National Provider Identifier
1689610404
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
8564 Issued in TX
Practice address
7700 San Felipe St Ste 340
Houston, TX 77063-1613
Phone
(713) 781-4072
Fax
(713) 952-4801
NPI assigned
Jun 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 8564 TX Primary

Addresses

Primary practice location

7700 San Felipe St Ste 340
Houston, TX 77063-1613

Mailing address

7700 San Felipe St Ste 340
Houston, TX 77063-1613
Phone (713) 781-4072

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
8564TXMDAssistant Behavior Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Patrick V Nicosia DDS Ms Inc Periodontics Past Accepting new patients

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": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689610404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7700 SAN FELIPE ST STE 340",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770631613",
            "telephone_number": "713-781-4072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7700 SAN FELIPE ST STE 340",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770631613",
            "telephone_number": "713-781-4072",
            "fax_number": "713-952-4801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICOSIA",
        "first_name": "PATRICK",
        "middle_name": "V.",
        "credential": "DDS, MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "TX",
            "license": "8564",
            "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 Jul 8, 2007; 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.