Individual provider Active NPI

Stavros Jacques Sofos, DDS, MS

  • Periodontics
  • The Woodlands, TX
National Provider Identifier
1821688862
Registry record updated Jun 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
37032 Issued in TX
Practice address
10110 Woodlands Pkwy Ste 1000
The Woodlands, TX 77382-2927
Phone
(713) 576-5133
NPI assigned
Jan 23, 2021
Last updated
Jun 19, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 0401418661 VA
Periodontics 1223P0300X 37032 TX Primary

Addresses

Primary practice location

10110 Woodlands Pkwy Ste 1000
The Woodlands, TX 77382-2927

Mailing address

10110 Woodlands Pkwy Ste 1000
The Woodlands, TX 77382-2927
Phone (281) 419-4655

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
37032TXMDPeriodontist
0401418661VAMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
SLS Periodontics PLLC Periodontics CurrentSince Mar 11, 2025 Accepting new patients

Locations

10110 Woodlands Pkwy
Ste 1000
The Woodlands, TX 77382
Phone (281) 419-4655

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": "1611360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750291200000",
    "number": "1821688862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10110 WOODLANDS PKWY STE 1000",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773822927",
            "telephone_number": "281-419-4655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10110 WOODLANDS PKWY STE 1000",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773822927",
            "telephone_number": "713-576-5133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOFOS",
        "first_name": "STAVROS",
        "middle_name": "JACQUES",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-23",
        "last_updated": "2025-06-19",
        "certification_date": "2025-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "VA",
            "license": "0401418661",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "TX",
            "license": "37032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in The Woodlands, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.