Jennifer Pitz Deck, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

24555 Issued in TX

Practice address

3000 Gaston Ave.
Ste 504C
Dallas, TX 75226

Phone

(214) 828-8241

NPI assigned

Jun 26, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Shelly K. Clark, Dentistry for Children

  • Pediatric Dentistry
  • Midlothian, TX
  • NPI 1821684929
  NPD (past)

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

{
    "created_epoch": "1245974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623369600000",
    "number": "1053549162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2014 FLAT CREEK PL",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750802318",
            "telephone_number": "214-865-8991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 GASTON AVE.",
            "address_2": "STE 504C",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75226",
            "telephone_number": "214-828-8241"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4450 E Highway 287",
            "address_purpose": "LOCATION",
            "city": "Midlothian",
            "state": "TX",
            "postal_code": "760655576",
            "country_code": "US",
            "telephone_number": "972-723-0111",
            "fax_number": "972-767-0944",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DECK",
        "first_name": "JENNIFER",
        "middle_name": "PITZ",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-26",
        "last_updated": "2021-06-11",
        "certification_date": "2021-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "0024555",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "024555",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "24555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John R Debus, M.D.
• Mary Decardenas, MPAS, PA-C
• Marsha Morrell Decay, CRNA
• Shagayla L. Decena, LPC
• Kaitlyn Marie Dechant, PSYD
• Danny Trew Deckard, PA
• Gary G Deckelboim, M.D.
• Jacqueline S Decker, PA-C
• M'Kinna Decker
• Marshal Neil Decker, ATP, RRTS

• Pediatric Dentistry in Dallas, TX
• Providers in Dallas, TX by specialty
• Pediatric Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2021; 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.