Individual provider Active NPI

Justin Ray Horne, D.D.S.

  • Pediatric Dentistry
  • Longview, TX
National Provider Identifier
1023163524
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
20796 Issued in TX
Practice address
5 Doctor Cir
Longview, TX 75605-5050
Phone
(903) 758-6406
Fax
(903) 758-8116
NPI assigned
Jan 24, 2007
Sex
Male
Sole proprietor
Yes

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
Pediatric Dentistry 1223P0221X 20796 TX Primary

Addresses

Primary practice location

5 Doctor Cir
Longview, TX 75605-5050

Mailing address

5 Doctor Cir
Longview, TX 75605-5050
Phone (903) 758-6406

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
20796TXMDPediatric Dentist

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023163524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 DOCTOR CIR",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756055050",
            "telephone_number": "903-758-6406",
            "fax_number": "903-758-8116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 DOCTOR CIR",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756055050",
            "telephone_number": "903-758-6406",
            "fax_number": "903-758-8116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORNE",
        "first_name": "JUSTIN",
        "middle_name": "RAY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "20796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.