Unknown Individual – Oral and Maxillofacial Surgery (Dentist), NPI 1104813294

Unknown Individual is a healthcare provider. based in Houston, Texas. specializing in Oral and Maxillofacial Surgery (Dentist). They hold a License No. 11122 (TX). The NPI Number for Unknown Individual is 1104813294

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1104813294
Phone
(281) 754-4921
Address
6430 FM 1960 RD W
Deactivation Date
14 June 2021
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • Lake Houston Church of the Nazarene, FM 1960, Kingwood Glen, Atascocita, Harris County, Texas, 77346, United States

    SUITE 200

    HOUSTON, TX 770693902

    Phone: (281) 754-4921

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 77069)

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Reviews

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Frequently asked questions

What number should I use to identify Unknown Individual for billing?
Administrative and clinical systems typically use NPI 1104813294 for Unknown Individual.
Does inactive mean outdated data for Unknown Individual?
Inactive status means the NPI record is not marked active in the public file — verify before making care decisions.
What type of care does Unknown Individual provide?
Unknown Individual's profile centers on Oral and Maxillofacial Surgery (Dentist). Clinical services aligned with this taxonomy classification.
What geographic area is tied to Unknown Individual?
Unknown Individual is associated with Houston, Texas in the same public data insurers reference.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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