Active NPI
Uttara Suresh
- Dentist
- Deer Park, TX
National Provider Identifier
1710505599
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 36293
- Practice address
- 3702 Center St
Deer Park, TX 77536-6104 - Phone
- (832) 460-1896
- NPI assigned
- Jul 8, 2020
- Last updated
- Jul 8, 2020
- Sex
- Female
- Sole proprietor
- No
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 | 36293 | TX | Primary |
Addresses
Primary practice location
3702 Center St
Deer Park, TX 77536-6104
Mailing address
1911 Holcombe Blvd Apt 1416
Houston, TX 77030-4189
Phone (716) 480-5367
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 |
|---|---|---|---|
| 36293 | TX | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1594166400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1594166400000",
"number": "1710505599",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1911 HOLCOMBE BLVD APT 1416",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770304189",
"telephone_number": "716-480-5367"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3702 CENTER ST",
"city": "DEER PARK",
"state": "TX",
"postal_code": "775366104",
"telephone_number": "832-460-1896"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SURESH",
"first_name": "UTTARA",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-07-08",
"last_updated": "2020-07-08",
"certification_date": "2020-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "36293",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Deer Park, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.