Individual provider Active NPI

Ifetayo A Griffith, DMD

  • Dentist
  • Houston, TX
National Provider Identifier
1720359383
Registry record updated Aug 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
21156 Issued in TX
Practice address
8313 Southwest Fwy Ste 177
Houston, TX 77074-1612
Phone
(713) 523-1666
Fax
(713) 523-8940
NPI assigned
Jan 13, 2012
Last updated
Aug 31, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 21156 TX
Dentist 122300000X 21156 TX Primary

Addresses

Primary practice location

8313 Southwest Fwy Ste 177
Houston, TX 77074-1612

Mailing address

PO Box 3000
Salem, OR 97302-8001
Phone (713) 523-1666

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
I20161005000735 TX Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1456649557

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Griffith Dental Associates Dentist CurrentSince Jan 2, 2022 Accepting new patients

Locations

1213 Hermann Dr
Ste 840
Houston, TX 77004

8313 Southwest Fwy
Ste 177
Houston, TX 77074
Phone (713) 523-1666

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1326412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630368000000",
    "number": "1720359383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3000",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973028001",
            "telephone_number": "713-523-1666",
            "fax_number": "713-523-8940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8313 SOUTHWEST FWY STE 177",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770741612",
            "telephone_number": "713-523-1666",
            "fax_number": "713-523-8940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIFFITH",
        "first_name": "IFETAYO",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-13",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "21156",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "21156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.