NPIMap

Organization Active NPI

Abc123 Dental in Keller PLLC

  • General Practice Dentistry
  • Keller, TX
National Provider Identifier
1104243898
Registry record updated Mar 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
24637 Issued in TX
Legal business name
ABC123 DENTAL IN KELLER PLLC
Practice address
460 Keller Pkwy Ste E
Keller, TX 76248-2370
Phone
(817) 656-1215
Fax
(877) 230-8349
NPI assigned
Mar 20, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2014

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

Authorized official

Name
Dr. Peter Vo, DDS
Title
Owner
Phone
(817) 656-1215

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 24637 TX Primary

Addresses

Primary practice location

460 Keller Pkwy Ste E
Keller, TX 76248-2370

Mailing address

460 Keller Pkwy Ste E
Keller, TX 76248-2370
Phone (817) 656-1215

Other names 1

  • ABC123 Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Abc123 Dental2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1395273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395273600000",
    "number": "1104243898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 KELLER PKWY STE E",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762482370",
            "telephone_number": "817-656-1215",
            "fax_number": "877-230-8349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 KELLER PKWY STE E",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762482370",
            "telephone_number": "817-656-1215",
            "fax_number": "877-230-8349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABC123 DENTAL IN KELLER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-20",
        "last_updated": "2014-03-20",
        "status": "A",
        "authorized_official_last_name": "VO",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-656-1215",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "24637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ABC123 Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Keller, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2014; 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.