Mary Jocelyn Elyse M Nisnisan, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

38984 Issued in TX

Practice address

3415 FM 762 Rd Ste 150
Richmond, TX 77469-5507

Phone

(832) 431-4316

Fax

(832) 476-0600

NPI assigned

Sep 13, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Dentists of Richmond PC

  • General Practice Dentistry
  • Richmond, TX
  • NPI 1255060760
  NPD

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

{
    "created_epoch": "1663027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663027200000",
    "number": "1811619299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2138 THISTLEROCK LN",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774798829",
            "telephone_number": "832-651-3240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3415 FM 762 RD STE 150",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774695507",
            "telephone_number": "832-431-4316",
            "fax_number": "832-476-0600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NISNISAN",
        "first_name": "MARY JOCELYN ELYSE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-13",
        "last_updated": "2022-09-13",
        "certification_date": "2022-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "38984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nick Knox Jr.
• Sheronda M Nickerson, BCBA
• Nicolest Healthcare Services Inc
• Ma. Ester Nightingale, PT
• Chisato Nishikawa, MD
• Nissi Rehab and Therapeutic Services
• Nissi Therapeutic Services
• Muriel Njei, LVN
• Priscilla Njoku
• Nina Nkem

• General Practice Dentistry in Richmond, TX
• Providers in Richmond, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.