Mission East Dallas and Metroplex Project, Inc.

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

MISSION EAST DALLAS AND METROPLEX PROJECT, INC.

Practice address

4550 Gus Thomasson Rd
Suite #26
Mesquite, TX 75150-1700

Phone

(972) 682-8917

NPI assigned

Jul 5, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Charles J Wiltraut

Title

Chief Executive Officer

Phone

(610) 349-7319

Specialties & licenses 1

Addresses

Other names 1

• Missoin East Dallas Doing business as

Tax ID family

Mission East Dallas and Metroplex Project Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Mission East Dallas and Metroplex Project, Inc.

  • Federally Qualified Health Center (FQHC)
  • Sachse, TX
  • NPI 1922718816
  NPD tax ID
• Mission East Dallas and Metroplex Project, Inc.

  • Federally Qualified Health Center (FQHC)
  • Sunnyvale, TX
  • NPI 1992416259
  NPD tax ID

Locations

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

{
    "created_epoch": "1467676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467676800000",
    "number": "1043662885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2914 OATES DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752283914",
            "telephone_number": "972-682-8917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4550 GUS THOMASSON RD",
            "address_2": "SUITE #26",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751501700",
            "telephone_number": "972-682-8917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSION EAST DALLAS AND METROPLEX PROJECT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-05",
        "last_updated": "2016-07-05",
        "status": "A",
        "authorized_official_last_name": "WILTRAUT",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "610-349-7319",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Missoin East Dallas",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dentist in Mesquite, TX
• Providers in Mesquite, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2016; 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.