Individual provider Active NPI

Jacquelyn Dang, MD

  • Dermatology Physician
  • Houston, TX
National Provider Identifier
1952930836
Registry record updated Jun 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
V1063 Issued in TX
Practice address
10701 Vintage Preserve Pkwy
Houston, TX 77070-2158
Phone
(713) 442-1500
NPI assigned
Apr 3, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X V1063 TX Primary

Addresses

Primary practice location

10701 Vintage Preserve Pkwy
Houston, TX 77070-2158

Mailing address

11511 Shadow Creek Pkwy
Pearland, TX 77584-7298
Phone (713) 442-0000

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240628002303 TX Practitioner - Dermatology 3476955386 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Loyola University of Chicago, Stritch School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kelsey-Seybold Medical Group, PLLCGroup PAC ID 9739093527, 941 clinicians

Practice addresses (Care Compare)

10701 Vintage Preserve Pkwy
Houston, TX 77070-2158
Phone (713) 442-1500

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Kelsey-Seybold Medical Group, PLLC Dermatology CurrentSince Jul 29, 2024 Accepting new patients

Locations

10701 Vintage Preserve Pkwy
Houston, TX 77070
Phone (713) 442-1500

2727 W Holcombe Blvd
Houston, TX 77025
Phone (713) 790-9412

201 Enterprise Ave
Ste 900
League City, TX 77573
Phone (713) 442-2826

7010 Highway 6
Missouri City, TX 77459
Phone (713) 442-4200

11511 Shadow Creek Pkwy
Pearland, TX 77584
Phone (713) 442-4997

2515 Business Center Dr
Pearland, TX 77584
Phone (713) 442-7200

Interoperability endpoints

  • Direct secure messaging: jdang84357@direct.kelsey-seybold.com

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": "1585872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719532800000",
    "number": "1952930836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11511 SHADOW CREEK PKWY",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775847298",
            "telephone_number": "713-442-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10701 VINTAGE PRESERVE PKWY",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770702158",
            "telephone_number": "713-442-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANG",
        "first_name": "JACQUELYN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-03",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "V1063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.