Organization Active NPI

Custer Endodontic Group PLLC

Doing business as Texas Endodontic Center

  • Dentist
  • Allen, TX
National Provider Identifier
1093384752
Registry record updated Aug 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
CUSTER ENDODONTIC GROUP PLLC
Doing business as
Texas Endodontic Center
Practice address
107 Suncreek Dr Ste 120
Allen, TX 75013-3672
Phone
(972) 330-5878
NPI assigned
Jun 17, 2021
Last updated
Aug 22, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2022

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

Authorized official

Name
Andrew Xu, DDS
Title
Manager
Phone
(972) 330-5878

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

107 Suncreek Dr Ste 120
Allen, TX 75013-3672

Mailing address

5000 Legacy Dr Ste 240
Plano, TX 75024-3112
Phone (972) 330-5878

Other names 1

  • Texas Endodontic Center Doing business as

National Provider Directory

National Provider Directory

Locations

107 Suncreek Dr
Ste 120
Allen, TX 75013
Phone (214) 547-9111

7965 Custer Rd
Ste 140
Plano, TX 75025

NPI Registry JSON

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

{
    "created_epoch": "1623888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661126400000",
    "number": "1093384752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 LEGACY DR STE 240",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750243112",
            "telephone_number": "972-330-5878",
            "fax_number": "972-370-3556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 SUNCREEK DR STE 120",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750133672",
            "telephone_number": "972-330-5878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUSTER ENDODONTIC GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-17",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-22",
        "status": "A",
        "authorized_official_last_name": "XU",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "972-330-5878",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Texas Endodontic Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Texas Endodontic Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Allen, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2022; 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.