Individual provider Active NPI

James Anthony Edmondson, D.D.S.

  • General Practice Dentistry
  • Denison, TX
National Provider Identifier
1013094606
Registry record updated Nov 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
09435 Issued in TX
Practice address
2415 S Austin Ave
Ste. 101
Denison, TX 75020-7741
Phone
(903) 327-8540
Fax
(903) 327-8749
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2012

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 09435 TX Primary

Addresses

Primary practice location

2415 S Austin Ave
Ste. 101
Denison, TX 75020-7741

Mailing address

2415 S Austin Ave
Ste. 101
Denison, TX 75020-7741
Phone (903) 327-8540

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
I20240714000075 TX Practitioner - Oral Surgery 7810200409 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
09435TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Affordable Dentist Near Me in Waco PLLC General Practice CurrentSince May 1, 2024 Accepting new patients
Affordable Dentures & Implants - Texas, PLLC General Practice Past Accepting new patients
Kirby Joe Robinson of Texas, DDS, P.C. Past Accepting new patients

Locations

4573 Lake Shore Dr
Waco, TX 76710
Phone (254) 339-1339

Networks

  • NM HMO C-SNP
  • TX HMO D-SNP

Organizations & group practices 3

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353369600000",
    "number": "1013094606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2415 S AUSTIN AVE",
            "address_2": "STE. 101",
            "city": "DENISON",
            "state": "TX",
            "postal_code": "750207741",
            "telephone_number": "903-327-8540",
            "fax_number": "903-327-8749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2415 S AUSTIN AVE",
            "address_2": "STE. 101",
            "city": "DENISON",
            "state": "TX",
            "postal_code": "750207741",
            "telephone_number": "903-327-8540",
            "fax_number": "903-327-8749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDMONDSON",
        "first_name": "JAMES",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2012-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "09435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denison, TX

Sources for this page

Verify at the official NPI Registry.