Individual provider Active NPI

Michael Ray McCulloch, DDS

  • Dentist
  • Katy, TX
National Provider Identifier
1891935367
Registry record updated Feb 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
11730 Issued in TX
Practice address
23020 Highland Knolls #B
Katy, TX 77494-8347
Phone
(281) 693-6427
Fax
(281) 693-4258
NPI assigned
Feb 24, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 11730 TX Primary

Addresses

Primary practice location

23020 Highland Knolls #B
Katy, TX 77494-8347

Mailing address

23020 Highland Knolls #B
Katy, TX 77494-8347
Phone (281) 693-6427

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
11730TXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Michael R McCulloch DDS PC Dentist Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1235433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235433600000",
    "number": "1891935367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23020 HIGHLAND KNOLLS #B",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774948347",
            "telephone_number": "281-693-6427",
            "fax_number": "281-693-4258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23020 HIGHLAND KNOLLS #B",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774948347",
            "telephone_number": "281-693-6427",
            "fax_number": "281-693-4258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLOCH",
        "first_name": "MICHAEL",
        "middle_name": "RAY",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-24",
        "last_updated": "2009-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "11730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Katy, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2009; 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.