Individual provider Active NPI

Simon George Kolath, D.D.S.

  • General Practice Dentistry
  • Mesquite, TX
National Provider Identifier
1013066570
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
20924 Issued in TX
Practice address
820 E Cartwright Rd Ste 140
Mesquite, TX 75149-6063
Phone
(972) 329-2442
Fax
(972) 329-2452
NPI assigned
Jan 10, 2007
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 20924 TX Primary

Addresses

Primary practice location

820 E Cartwright Rd Ste 140
Mesquite, TX 75149-6063

Mailing address

820 E Cartwright Rd Ste 140
Mesquite, TX 75149-6063
Phone (972) 329-2442

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
I20160627001936 TX Order and Referring Only - DentistPractitioner - Dentist 4981995602

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
DRS. Dyer & Kolath, P.a. General Practice Past Accepting new patients

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": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013066570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 E CARTWRIGHT RD STE 140",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751496063",
            "telephone_number": "972-329-2442",
            "fax_number": "972-329-2452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 E CARTWRIGHT RD STE 140",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751496063",
            "telephone_number": "972-329-2442",
            "fax_number": "972-329-2452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLATH",
        "first_name": "SIMON",
        "middle_name": "GEORGE",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "20924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesquite, TX

Sources for this page

Verify at the official NPI Registry.