Active NPI
Mercedes Dillard, DDS
- General Practice Dentistry
- Pearland, TX
National Provider Identifier
1730923368
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 40634
- Practice address
- 12568 Broadway St Ste 140
Pearland, TX 77584-8968 - Phone
- (281) 975-2021
- NPI assigned
- Jun 19, 2024
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 40634 | TX | Primary |
Addresses
Primary practice location
12568 Broadway St Ste 140
Pearland, TX 77584-8968
Mailing address
2601 Westheimer Rd Apt C719
Houston, TX 77098-1694
Phone (501) 326-1997
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 |
|---|---|---|---|
| 40634 | TX | MD | Nuclear Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1718755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719360000000",
"number": "1730923368",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2601 WESTHEIMER RD APT C719",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770981694",
"telephone_number": "501-326-1997"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12568 BROADWAY ST STE 140",
"city": "PEARLAND",
"state": "TX",
"postal_code": "775848968",
"telephone_number": "281-975-2021"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DILLARD",
"first_name": "MERCEDES",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-06-19",
"last_updated": "2024-06-26",
"certification_date": "2024-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "40634",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pearland, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.