Todd Martin Pennartz, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

18144 Issued in TX

Practice address

1905 W Walker St
Breckenridge, TX 76424

Phone

(254) 559-2122

Fax

(254) 559-2153

NPI assigned

Aug 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563408000000",
    "number": "1083623326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 W WALKER ST",
            "city": "BRECKENRIDGE",
            "state": "TX",
            "postal_code": "76424",
            "telephone_number": "254-559-2122",
            "fax_number": "254-559-2153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 W WALKER ST",
            "city": "BRECKENRIDGE",
            "state": "TX",
            "postal_code": "76424",
            "telephone_number": "254-559-2122",
            "fax_number": "254-559-2153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNARTZ",
        "first_name": "TODD",
        "middle_name": "MARTIN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2019-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "18144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristie Oyler, P.T.
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• Cynthia Anne Perry, M.D.
• William Elmo Prater, M.D.
• Rachael Kendra Dabelic, M.D. P.a.
• Senior Health - Villa Haven, LLC
• Shackelford County Community Resource Center

• General Practice Dentistry in Breckenridge, TX
• Providers in Breckenridge, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.