Organization Active NPI

Brett Potter DMD PLLC

  • Endodontics
  • Victoria, TX
National Provider Identifier
1053781039
Registry record updated Oct 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
Legal business name
BRETT POTTER DMD PLLC
Practice address
103 Professional Park Dr
Victoria, TX 77904-2351
Phone
(361) 576-1235
NPI assigned
Oct 2, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2015

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

Authorized official

Name
Dr. Brett Potter, DMD
Title
Owner
Phone
(216) 262-8560

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223E0200X Primary

Addresses

Primary practice location

103 Professional Park Dr
Victoria, TX 77904-2351

Mailing address

103 Professional Park Dr
Victoria, TX 77904-2351
Phone (361) 576-1235

Other names 1

  • Victoria Endodontics Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1443744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443744000000",
    "number": "1053781039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 PROFESSIONAL PARK DR",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779042351",
            "telephone_number": "361-576-1235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 PROFESSIONAL PARK DR",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779042351",
            "telephone_number": "361-576-1235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRETT POTTER DMD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-02",
        "last_updated": "2015-10-02",
        "status": "A",
        "authorized_official_last_name": "POTTER",
        "authorized_official_first_name": "BRETT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "216-262-8560",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Victoria Endodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Victoria, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2015; 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.