Individual provider Active NPI

Madhu K Nair, DMD MS PHD

  • Oral and Maxillofacial Radiology Dentistry
  • Richardson, TX
National Provider Identifier
1952370322
Registry record updated Oct 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Radiology DentistryTaxonomy code 1223X0008X
License
DTP438 Issued in FL
Practice address
2600 Fairfield Dr
Richardson, TX 75082-5202
Phone
(682) 325-9558
Fax
(440) 575-0289
NPI assigned
Mar 16, 2006
Last updated
Oct 13, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Radiology Dentistry 1223X0008X DTP438 FL Primary
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X DTP438 FL

Addresses

Primary practice location

2600 Fairfield Dr
Richardson, TX 75082-5202

Mailing address

2600 Fairfield Dr
Richardson, TX 75082-5202
Phone (682) 325-9558

Other practice location 1

1600 SW Archer Rd
Gainesville, FL 32610-3003
Phone (352) 392-2505

Other identifiers 1

IdentifierTypeStateIssuer
076005600MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210826000074 TX Practitioner - Oral Surgery 7911931647 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
33361TXMDClinical Child & Adolescent Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Texas a&M University System Health Science Center Oral & Maxillofacial Surgery CurrentSince May 21, 2021 Accepting new patients
University Dental Health Services, Inc. Oral & Maxillofacial Surgery Past Accepting new patients
Austin Geriatric Specialists, PLLC Past Accepting new patients

Locations

3000 Gaston Ave
Dallas, TX 75226
Phone (214) 828-8100

3302 Gaston Ave
Dallas, TX 75246
Phone (214) 828-8100

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/18292/brand/1/csg/1/fhir/r4
  • FHIR API: https://api.platform.athenahealth.com/25850/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539388800000",
    "number": "1952370322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 FAIRFIELD DR",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750825202",
            "telephone_number": "682-325-9558",
            "fax_number": "440-575-0289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 FAIRFIELD DR",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750825202",
            "telephone_number": "682-325-9558",
            "fax_number": "440-575-0289"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 SW Archer Rd",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326103003",
            "country_code": "US",
            "telephone_number": "352-392-2505",
            "fax_number": "352-392-2507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NAIR",
        "first_name": "MADHU",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "DMD MS PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-16",
        "last_updated": "2018-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0008X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Radiology",
            "state": "FL",
            "license": "DTP438",
            "primary": true
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "FL",
            "license": "DTP438",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "076005600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richardson, TX

Sources for this page

Verify at the official NPI Registry.