Provider Demographics
NPI:1417209446
Name:POINDEXTER, GREGORY S (DDS)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:S
Last Name:POINDEXTER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12016 CEDAR CREEK DR
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-1641
Mailing Address - Country:US
Mailing Address - Phone:615-403-7534
Mailing Address - Fax:
Practice Address - Street 1:6102 SCOTT ST STE E
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77021
Practice Address - Country:US
Practice Address - Phone:281-519-0725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-15
Last Update Date:2019-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX295041223P0221X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No1223G0001XDental ProvidersDentistGeneral Practice