Custer Endodontic Group PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

CUSTER ENDODONTIC GROUP PLLC

Practice address

107 Suncreek Dr Ste 120
Allen, TX 75013-3672

Phone

(972) 330-5878

NPI assigned

Jun 17, 2021

Organization subpart

No

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

Addresses

Other names 1

• Texas Endodontic Center Doing business as

Locations

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"
        }
    ]
}

• Samantha Culbertson
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• Dentist in Allen, TX
• Providers in Allen, TX by specialty
• Dentist in Texas

• 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.