Organization Active NPI

North Dallas ENT Group

  • Specialist
  • Dallas, TX
National Provider Identifier
1043336860
Registry record updated Jul 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
NORTH DALLAS ENT GROUP
Practice address
12720 Hillcrest Rd Ste 900
Dallas, TX 75230-2047
Phone
(972) 566-8300
Fax
(972) 566-8004
NPI assigned
Mar 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2025

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

Authorized official

Name
Mrs. Michelle Denise Banno
Title
Office Manager
Phone
(972) 566-4071

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

12720 Hillcrest Rd Ste 900
Dallas, TX 75230-2047

Mailing address

9330 LBJ Fwy Ste 800
Dallas, TX 75243-4310
Phone (972) 566-8300

Other identifiers 3

IdentifierTypeStateIssuer
0063PMOtherTXBLUE CROSS OF TEXAS
0077HROtherTXTRONE BCTX
110688201MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080311000125 TX Part B Supplier - Clinic/Group Practice 8820015126 Receives reassigned benefits from 2 practitioners
Practice locations: Dallas, TX

National Provider Directory

National Provider Directory

Locations

7777 Forest Ln
Ste B432
Dallas, TX 75230
Phone (972) 566-8300

12720 Hillcrest Rd
Ste 900
Dallas, TX 75230
Phone (972) 566-8300

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EABEDD

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753833600000",
    "number": "1043336860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9330 LBJ FWY STE 800",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752434310",
            "telephone_number": "972-566-8300",
            "fax_number": "972-566-8004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12720 HILLCREST RD STE 900",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752302047",
            "telephone_number": "972-566-8300",
            "fax_number": "972-566-8004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH DALLAS ENT GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2025-07-30",
        "certification_date": "2025-07-30",
        "status": "A",
        "authorized_official_last_name": "BANNO",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "DENISE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "972-566-4071",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF TEXAS",
            "identifier": "0063PM",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRONE BCTX",
            "identifier": "0077HR",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110688201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.