NPIMap

Organization Active NPI

Jay L. Nutt & C. Fred Pietsch, DDS, Inc

  • Oral and Maxillofacial Surgery (Dentist)
  • Richardson, TX
National Provider Identifier
1053441667
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
12807 Issued in TX
Legal business name
JAY L. NUTT & C. FRED PIETSCH, DDS, INC
Practice address
1231 E Belt Line Rd
Suite 103
Richardson, TX 75081-3748
Phone
(972) 690-8617
Fax
(972) 690-6423
NPI assigned
Mar 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
C Fred Pietsch, DDS
Title
President
Phone
(972) 690-8617

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 10340 TX
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 10482 TX
PeriodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0300X 19473 TX
Oral and Maxillofacial Surgery (Dentist)Group: 193200000X MULTI-SPECIALTY GROUP 1223S0112X 12807 TX Primary

Addresses

Primary practice location

1231 E Belt Line Rd
Suite 103
Richardson, TX 75081-3748

Mailing address

1231 E Belt Line Rd
Suite 103
Richardson, TX 75081-3748
Phone (972) 690-8617

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.

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1053441667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1231 E BELT LINE RD",
            "address_2": "SUITE 103",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750813748",
            "telephone_number": "972-690-8617",
            "fax_number": "972-690-6423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1231 E BELT LINE RD",
            "address_2": "SUITE 103",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750813748",
            "telephone_number": "972-690-8617",
            "fax_number": "972-690-6423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAY L. NUTT & C. FRED PIETSCH, DDS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "PIETSCH",
        "authorized_official_first_name": "C",
        "authorized_official_middle_name": "FRED",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-690-8617",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "10340",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "10482",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "TX",
            "license": "19473",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "12807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richardson, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.