Individual provider Active NPI

Blake Dyson Maida, DDS, MD

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Houston, TX
National Provider Identifier
1891923843
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
24660 Issued in TX
Practice address
7500 San Felipe St Ste 300
Houston, TX 77063-1716
Phone
(713) 457-6337
Fax
(713) 457-6341
NPI assigned
Jun 29, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 24660 TX Primary

Addresses

Primary practice location

7500 San Felipe St Ste 300
Houston, TX 77063-1716

Mailing address

7500 San Felipe St Ste 300
Houston, TX 77063-1716
Phone (713) 457-6337

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
24660TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Houston Oral Surgery Associates, PLLC CurrentSince Jul 24, 2022 Accepting new patients
Houston Oral Surgery Associates, P.a. Oral & Maxillofacial Surgery PastSince Jul 24, 2022 Accepting new patients

Locations

7500 San Felipe St
Ste 300
Houston, TX 77063
Phone (713) 457-6337

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": "1246233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1891923843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7500 SAN FELIPE ST STE 300",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770631716",
            "telephone_number": "713-457-6337",
            "fax_number": "713-457-6341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7500 SAN FELIPE ST STE 300",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770631716",
            "telephone_number": "713-457-6337",
            "fax_number": "713-457-6341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAIDA",
        "first_name": "BLAKE",
        "middle_name": "DYSON",
        "name_prefix": "Dr.",
        "credential": "DDS, MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-29",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "TX",
            "license": "24660",
            "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 21, 2022; 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.