Individual provider Active NPI

Dwayne Scott Dull, DDS

  • Dentist
  • Houston, TX
National Provider Identifier
1841370194
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
11638 Issued in TX
Practice address
14441 Memorial Drive
Suite 21
Houston, TX 77079
Phone
(281) 497-3382
Fax
(281) 497-8105
NPI assigned
Oct 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 11638 TX Primary

Addresses

Primary practice location

14441 Memorial Drive
Suite 21
Houston, TX 77079

Mailing address

14441 Memorial Drive
Suite 21
Houston, TX 77079
Phone (281) 497-3382

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

LicenseStateTypeSpecialty
11638TXMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1841370194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14441 MEMORIAL DRIVE",
            "address_2": "SUITE 21",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77079",
            "telephone_number": "281-497-3382",
            "fax_number": "281-497-8105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14441 MEMORIAL DRIVE",
            "address_2": "SUITE 21",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77079",
            "telephone_number": "281-497-3382",
            "fax_number": "281-497-8105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DULL",
        "first_name": "DWAYNE",
        "middle_name": "SCOTT",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "11638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.