Individual provider Active NPI

Robert H Poindexter, DDS

  • Dentist
  • Kerrville, TX
National Provider Identifier
1720129364
Registry record updated Sep 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
14432 Issued in TX
Practice address
817 Sidney Baker
Kerrville, TX 78028-3350
Phone
(830) 896-3804
Fax
(830) 896-3223
NPI assigned
Feb 8, 2007
Last updated
Sep 21, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 14432 TX Primary

Addresses

Primary practice location

817 Sidney Baker
Kerrville, TX 78028-3350

Mailing address

817 Sidney Baker
Kerrville, TX 78028-3350
Phone (830) 896-3804

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140429001934 TX Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7517190481

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14432TXMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253491200000",
    "number": "1720129364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 SIDNEY BAKER",
            "city": "KERRVILLE",
            "state": "TX",
            "postal_code": "780283350",
            "telephone_number": "830-896-3804",
            "fax_number": "830-896-3223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "817 SIDNEY BAKER",
            "city": "KERRVILLE",
            "state": "TX",
            "postal_code": "780283350",
            "telephone_number": "830-896-3804",
            "fax_number": "830-896-3223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POINDEXTER",
        "first_name": "ROBERT",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-08",
        "last_updated": "2009-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "14432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kerrville, TX

Sources for this page

Verify at the official NPI Registry.