Individual provider Active NPI

Elizabeth Kruse Shriver, D.D.S.

  • Dentist
  • Dickinson, TX
National Provider Identifier
1912347824
Registry record updated Jul 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
29157 Issued in TX
Practice address
1620 FM 646 Rd W Ste D
Dickinson, TX 77539-4580
Phone
(832) 200-2700
NPI assigned
Jun 25, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 29157 TX Primary

Addresses

Primary practice location

1620 FM 646 Rd W Ste D
Dickinson, TX 77539-4580

Mailing address

1620 FM 646 Rd W Ste D
Dickinson, TX 77539-4580
Phone (281) 332-0980

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
29157TXMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1372118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626825600000",
    "number": "1912347824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 FM 646 RD W STE D",
            "city": "DICKINSON",
            "state": "TX",
            "postal_code": "775394580",
            "telephone_number": "281-332-0980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 FM 646 RD W STE D",
            "city": "DICKINSON",
            "state": "TX",
            "postal_code": "775394580",
            "telephone_number": "832-200-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHRIVER",
        "first_name": "ELIZABETH",
        "middle_name": "KRUSE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-25",
        "last_updated": "2021-07-21",
        "certification_date": "2021-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "29157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dickinson, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2021; 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.