Edward A Neusel, DDS – Pediatric Dentistry

Key facts

NPI: 1104094226
Entity type: Individual (NPI type 1)
Primary specialty: Pediatric Dentistry 1223P0221X
License: 10828 (TX)
Practice address: 215 E Avenue G
Silsbee, TX 77656-4141
Phone: (409) 385-3651
NPI assigned: Feb 11, 2008
Sex: Male
Sole proprietor: Yes

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
10828	TX	MD	Addiction (Substance Use Disorder) Counselor

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Pediatric Dentistry	1223P0221X	10828	TX	Yes

Addresses

Primary practice location

215 E Avenue G
Silsbee, TX 77656-4141

Mailing address

14 Pascal LN
Austin, TX 78746-3203
Phone (512) 382-1406

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 11, 2008.

{
    "created_epoch": "1202688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202688000000",
    "number": "1104094226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 PASCAL LN",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787463203",
            "telephone_number": "512-382-1406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 E AVENUE G",
            "city": "SILSBEE",
            "state": "TX",
            "postal_code": "776564141",
            "telephone_number": "409-385-3651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEUSEL",
        "first_name": "EDWARD",
        "middle_name": "A",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-11",
        "last_updated": "2008-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "10828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Silsbee, TX

All providers in Silsbee, TX · Pediatric Dentistry in Texas

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 11, 2008. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.