Active NPI
Martin Dennis
- Pharmacist
- Flower Mound, TX
National Provider Identifier
1104291392
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 33507
- Practice address
- 2409 Timber Ridge LN
Flower Mound, TX 75028-7503 - Phone
- (214) 473-8682
- Fax
- (214) 291-0816
- NPI assigned
- Dec 14, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 33507 | TX | Primary |
Addresses
Primary practice location
2409 Timber Ridge LN
Flower Mound, TX 75028-7503
Mailing address
2409 Timber Ridge LN
Flower Mound, TX 75028-7503
Phone (214) 473-8682
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 145494 | Medicaid | TX | |
| 33507 | Other | TX | STATE PHARMACY LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33507 | TX | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1450051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1450051200000",
"number": "1104291392",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2409 TIMBER RIDGE LN",
"city": "FLOWER MOUND",
"state": "TX",
"postal_code": "750287503",
"telephone_number": "214-473-8682",
"fax_number": "214-291-0816"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2409 TIMBER RIDGE LN",
"city": "FLOWER MOUND",
"state": "TX",
"postal_code": "750287503",
"telephone_number": "214-473-8682",
"fax_number": "214-291-0816"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DENNIS",
"first_name": "MARTIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-12-14",
"last_updated": "2015-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "33507",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "145494",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE PHARMACY LICENSE",
"identifier": "33507",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Flower Mound, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.