Heritage Trace Dental, PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

HERITAGE TRACE DENTAL, PA

Practice address

4160 Heritage Trace Pkwy
Suite 408
Keller, TX 76248-1312

Phone

(817) 741-4288

NPI assigned

Aug 19, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Brett Nielsen, DDS

Title

Vice President

Phone

(817) 741-4288

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1219104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219104000000",
    "number": "1013164284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4160 HERITAGE TRACE PKWY",
            "address_2": "SUITE 408",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762481313",
            "telephone_number": "817-741-4288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4160 HERITAGE TRACE PKWY",
            "address_2": "SUITE 408",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762481312",
            "telephone_number": "817-741-4288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE TRACE DENTAL, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-19",
        "last_updated": "2008-08-19",
        "status": "A",
        "authorized_official_last_name": "NIELSEN",
        "authorized_official_first_name": "BRETT",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "817-741-4288",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carrie Henderson
• Karman Kallio Hendricks, LCSW
• Michael Hennessy, RBT
• Anne E Henriques, RN
• Sheila Dawn Hensley, LPC
• Selene Hernandez Jaramillo
• Abigail Hernandez
• Hannah Hernandez
• Jacqueline Hernandez, SLP
• Jacob Ryan Herring, DC

• General Practice Dentistry in Keller, TX
• Providers in Keller, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.