Organization Active NPI

Mabank Family Dentistry PLLC

  • General Practice Dentistry
  • Mabank, TX
National Provider Identifier
1033772447
Registry record updated Apr 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
MABANK FAMILY DENTISTRY PLLC
Practice address
302 N 3Rd St
Mabank, TX 75147-8611
Phone
(903) 887-4405
NPI assigned
Apr 22, 2019
Last updated
Apr 22, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2019

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

Authorized official

Name
Faith Gaskins
Title
Director of Credentialing
Phone
(972) 869-3789

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

302 N 3Rd St
Mabank, TX 75147-8611

Mailing address

2403 Lacy LN
Carrollton, TX 75006-6514
Phone (972) 869-3789

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1555891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555891200000",
    "number": "1033772447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2403 LACY LN",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750066514",
            "telephone_number": "972-869-3789",
            "fax_number": "972-590-8809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 N 3RD ST",
            "city": "MABANK",
            "state": "TX",
            "postal_code": "751478611",
            "telephone_number": "903-887-4405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MABANK FAMILY DENTISTRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-22",
        "last_updated": "2019-04-22",
        "status": "A",
        "authorized_official_last_name": "GASKINS",
        "authorized_official_first_name": "FAITH",
        "authorized_official_title_or_position": "DIRECTOR OF CREDENTIALING",
        "authorized_official_telephone_number": "972-869-3789"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mabank, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2019; 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.