Dental Provider Resources 4

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

DENTAL PROVIDER RESOURCES 4

Doing business as

Complete Dental Care

Practice address

1000 Texan TRL
Ste 229
Grapevine, TX 76051-3776

Phone

(817) 328-6150

Fax

(866) 882-1702

NPI assigned

Nov 28, 2012

Organization subpart

No

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

Authorized official

Name

Jared Bruggeman, DDS

Title

Owner/Doctor

Phone

(817) 328-6153

Specialties & licenses 1

Addresses

Other names 1

• Complete Dental Care Doing business as

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

{
    "created_epoch": "1354060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354060800000",
    "number": "1013252246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 TEXAN TRL",
            "address_2": "STE 229",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760513776",
            "telephone_number": "817-328-6150",
            "fax_number": "866-882-1702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 TEXAN TRL",
            "address_2": "STE 229",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760513776",
            "telephone_number": "817-328-6150",
            "fax_number": "866-882-1702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL PROVIDER RESOURCES 4",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-28",
        "last_updated": "2012-11-28",
        "status": "A",
        "authorized_official_last_name": "BRUGGEMAN",
        "authorized_official_first_name": "JARED",
        "authorized_official_title_or_position": "OWNER/DOCTOR",
        "authorized_official_telephone_number": "817-328-6153",
        "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": [
        {
            "organization_name": "Complete Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Deformity Reconstruction Specialists PLLC
• Jenna Kathryn Deggs, DPT
• Christy Delgado
• Katrina Yvonne Deloney, LPC-S
• Robert V. Demartini, M.D.
• Amy Louise Depue, D.O.
• Dermasurgery Specialist, PLLC
• Dermatology Solutions PLLC
• Julianne Devlin, BCBA
• DFW Neighborhood Home Care, LLC

• General Practice Dentistry in Grapevine, TX
• Providers in Grapevine, 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 Nov 28, 2012; 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.