DR. PRASHANTH RAVI DMD
NPI 1356577175
Dentist - Oral and Maxillofacial Surgery in Pasadena, TX

Active since June 08, 2009Opted out of Medicare · through Oct 21, 2027
4007 WOODLAWN AVE, PASADENA, TX 77504(713) 944-0864(713) 944-7737 Get Directions Write a Review

NPPES record last updated: July 7, 2021. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Dr. Prashanth Ravi Dmd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. PRASHANTH RAVI DMD (NPI 1356577175) is an individual oral and maxillofacial surgery provider in Pasadena, Texas, licensed in Texas (29763) and active in the NPI registry since June 2009. He has opted out of Medicare through October 21, 2027 and remains eligible to order and refer and maintains a secondary practice location in Beaumont.

NPPES Registry Identity

NPI1356577175
Entity TypeIndividualMale
Primary Taxonomy1223S0112X
Provider Legal NameDR. PRASHANTH RAVICredential: DMD
Location Address4007 WOODLAWN AVEPasadena, TX 77504-1910
Mailing Address2929 Calder St Ste 302, Suite 302Beaumont, TX 77702-1831 · (409) 832-2532
Fax(713) 944-7737
Sole ProprietorNo
Enumeration DateJune 8, 2009
Last NPPES UpdateJuly 7, 2021
NPPES CertifiedJuly 7, 2021
NPI 1356577175 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
License Licensed in TX · 29763
Definition

An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

4007 WOODLAWN AVE, Pasadena, TX 77504

Secondary Practice Location 1

Location 12929 Calder St Ste 302, Suite 302Beaumont, TX 77702-1831 · Phone (409) 832-2532

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Dr. Prashanth Ravi Dmd has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from October 21, 2019 through October 21, 2027.

Opt-Out Effective DateOctober 21, 2019
Opt-Out In Effect ThroughOctober 21, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 77504 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$90.40 typical visit price
range $58.24 – $176.98
Typical copayment $22.60 (range $14.56 – $44.24)
Most-billed visit code 99203
Established Patient
$72.62 typical visit price
range $18.60 – $143.93
Typical copayment $18.15 (range $4.65 – $35.98)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Clinic/Center (Ambulatory Surgical)
4007 WOODLAWN AVE
PASADENA, TX 77504
Dentist (Oral and Maxillofacial Surgery)
4007 WOODLAWN AVE
PASADENA, TX 77504

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1356577175, enumerated as an "individual" on June 08, 2009.

The provider is located at 4007 WOODLAWN AVE PASADENA, TX 77504 and the phone number is (713) 944-0864.

Dentist with taxonomy code 1223S0112X and a focus in Oral and Maxillofacial Surgery.

The provider might be accepting Accepts: Delta Dental PPO, Guardian and Humana. Please consult your insurance carrier or call the provider to verify.