Individual provider Active NPI

Randall David Meyer, DDS

  • General Practice Dentistry
  • Waco, TX
National Provider Identifier
1114133840
Registry record updated Dec 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
22282 Issued in TX
Practice address
715 N 64TH St
Waco, TX 76710-4387
Phone
(254) 772-3922
Fax
(254) 776-6230
NPI assigned
May 16, 2007
Last updated
Dec 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 22282 TX Primary

Addresses

Primary practice location

715 N 64TH St
Waco, TX 76710-4387

Mailing address

3109 Olton Rd Ste 302C
Winchester Plaza Box 5027
Plainview, TX 79072-6763
Phone (806) 296-7666

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

LicenseStateTypeSpecialty
22282TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Health Associates of Texas, PC General Practice PastSince Dec 14, 2025 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765411200000",
    "number": "1114133840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3109 OLTON RD STE 302C",
            "address_2": "WINCHESTER PLAZA BOX 5027",
            "city": "PLAINVIEW",
            "state": "TX",
            "postal_code": "790726763",
            "telephone_number": "806-296-7666",
            "fax_number": "806-296-7673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 N 64TH ST",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767104387",
            "telephone_number": "254-772-3922",
            "fax_number": "254-776-6230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEYER",
        "first_name": "RANDALL",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-16",
        "last_updated": "2025-12-11",
        "certification_date": "2025-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "22282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2025; 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.