Fresh Dental-Longview

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

FRESH DENTAL-LONGVIEW

Practice address

7301 State Highway 161 Ste 198
Irving, TX 75039-2880

Phone

(972) 869-3789

Fax

(972) 869-3791

NPI assigned

Nov 28, 2011

Organization subpart

No

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

Authorized official

Name

Mary Pu

Title

VP of Finance

Phone

(972) 869-3789

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1322438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322438400000",
    "number": "1083981641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7301 STATE HIGHWAY 161 STE 198",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750392880",
            "telephone_number": "972-869-3789",
            "fax_number": "972-869-3791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7301 STATE HIGHWAY 161 STE 198",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750392880",
            "telephone_number": "972-869-3789",
            "fax_number": "972-869-3791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRESH DENTAL-LONGVIEW",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-28",
        "last_updated": "2011-11-28",
        "status": "A",
        "authorized_official_last_name": "PU",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "VP OF FINANCE",
        "authorized_official_telephone_number": "972-869-3789"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Freedom Home Care Club of Texas, Inc.
• Hunter Freeman
• Megan Freeman
• Patrick S Freeman, MD
• Fresh Dental-Bossier City
• Fresh Dental-Shreveport
• Skyler Dawn Friel, PT, DPT
• Rodney R Fritz, M.D.
• Robert Max Frohm, M.D.
• Frontera Labs, LLC

• Dentist in Irving, TX
• Providers in Irving, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2011; 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.