Individual provider Active NPI

Matthew Thomas Henehan, D.D.S

  • General Practice Dentistry
  • Cypress, TX
National Provider Identifier
1811949795
Registry record updated Feb 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
20991 Issued in TX
Practice address
17330 Spring Cypress Rd Ste 115
Cypress, TX 77429-4294
Phone
(281) 256-3222
NPI assigned
May 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 20991 TX Primary

Addresses

Primary practice location

17330 Spring Cypress Rd Ste 115
Cypress, TX 77429-4294

Mailing address

17330 Spring Cypress Rd Ste 115
Cypress, TX 77429-4294
Phone (281) 256-3222

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
I20150731016919 TX Order and Referring Only - DentistPractitioner - Dentist 1052625274

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20991TXMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Premier Dental - Spring Branch, PLLC General Practice Past Accepting new patients
Aliasgar Y Mogri DDS PA General Practice Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204070400000",
    "number": "1811949795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17330 SPRING CYPRESS RD STE 115",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774294294",
            "telephone_number": "281-256-3222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17330 SPRING CYPRESS RD STE 115",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774294294",
            "telephone_number": "281-256-3222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENEHAN",
        "first_name": "MATTHEW",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2008-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "20991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cypress, TX

Sources for this page

Verify at the official NPI Registry.