Affordable Dentures & Implants - Texas VI, PLLC

Key facts

NPI

1053196469

Entity type

Organization (NPI type 2)

Primary specialty

General Practice Dentistry 1223G0001X

Legal business name

AFFORDABLE DENTURES & IMPLANTS - TEXAS VI, PLLC

Practice address

1522 S New Rd
Waco, TX 76711-1316

Phone

(254) 224-6810

NPI assigned

Aug 25, 2023

Organization subpart

No

Authorized official

Name

Haley Wooster

Title

Enrollment/Credentialing Manager

Phone

(984) 251-8846

National Provider Directory

Specialties & licenses

Addresses

Other names

• Affordable Dentures & Implants - Waco Doing business as

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 18, 2024.

{
    "created_epoch": "1692921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729209600000",
    "number": "1053196469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1522 S NEW RD",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767111316",
            "telephone_number": "254-224-6810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1522 S NEW RD",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767111316",
            "telephone_number": "254-224-6810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFFORDABLE DENTURES & IMPLANTS - TEXAS VI, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-25",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A",
        "authorized_official_last_name": "WOOSTER",
        "authorized_official_first_name": "HALEY",
        "authorized_official_title_or_position": "ENROLLMENT/CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "984-251-8846"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Affordable Dentures & Implants - Waco",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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