Individual provider Active NPI

Venkat Veerisetty, DMD

  • General Practice Dentistry
  • Houston, TX
National Provider Identifier
1972611705
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
17377 Issued in TX
Practice address
906 Wayside Dr
Houston, TX 77011-2518
Phone
(713) 923-2506
Fax
(713) 923-1943
NPI assigned
Aug 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 17377 TX Primary

Addresses

Primary practice location

906 Wayside Dr
Houston, TX 77011-2518

Mailing address

906 Wayside Dr
Houston, TX 77011-2518
Phone (713) 923-2506

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
I20160617000117 TX Practitioner - Oral Surgery 7810288164 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17377TXMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Stephen F Austin Community Health Center,Inc CurrentSince May 15, 2016 Accepting new patients
Stephen F. Austin Community Health Center, Inc. CurrentSince May 15, 2016 Accepting new patients

Locations

1111 W Adoue St
Alvin, TX 77511
Phone 2818241480 ext. 1594

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": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972611705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "906 WAYSIDE DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770112518",
            "telephone_number": "713-923-2506",
            "fax_number": "713-923-1943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "906 WAYSIDE DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770112518",
            "telephone_number": "713-923-2506",
            "fax_number": "713-923-1943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEERISETTY",
        "first_name": "VENKAT",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "17377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.