Justin Hall Nylander, D.M.D.
Individual provider Active NPI Dentist · Allen, TX
NPI 1033396205 · NPPES record last updated May 24, 2016
Key facts
- NPI
- 1033396205
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 27875 (TX)
- Practice address
- 551 W McDermott Dr
Allen, TX 75013-2705 - Phone
- (972) 359-9950
- NPI assigned
- Jan 29, 2008
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27875 | TX | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Allen Dentistry | Past | Accepting new patients | |
| Silver Lake Dental | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 27875 | TX | Yes |
Addresses
Primary practice location
551 W McDermott Dr
Allen, TX 75013-2705
Mailing address
551 W McDermott Dr
Allen, TX 75013-2705
Phone (972) 359-9950
Other providers in Allen, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 24, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.