NPIMap

Organization Active NPI

Dental Professionals of Texas, P.a.

  • General Practice Dentistry
  • Dallas, TX
National Provider Identifier
1114453081
Registry record updated Jun 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DENTAL PROFESSIONALS OF TEXAS, P.A.
Practice address
4849 Greenville Ave Ste 173
Dallas, TX 75206-4187
Phone
(214) 369-9966
NPI assigned
May 11, 2017
Organization subpart
Yes
Parent organization
DENTAL HEALTH ASSOCIATES OF TEXAS, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 26, 2017

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

Authorized official

Name
Cassandra Nichole Teutsch
Title
Credentialing Coordinator
Phone
(217) 540-8972

Specialties & licenses 1

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

Addresses

Primary practice location

4849 Greenville Ave Ste 173
Dallas, TX 75206-4187

Mailing address

4849 Greenville Ave Ste 173
Dallas, TX 75206-4187
Phone (217) 540-8972

Other names 1

  • Energy Square Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dental Professionals of Texas PA13 organizations share this tax ID, including this one
Part of
Dental Professionals of Texas PA

Other organizations with this tax ID 12

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

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498435200000",
    "number": "1114453081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4849 GREENVILLE AVE STE 173",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752064187",
            "telephone_number": "217-540-8972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4849 GREENVILLE AVE STE 173",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752064187",
            "telephone_number": "214-369-9966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL PROFESSIONALS OF TEXAS, P.A.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENTAL HEALTH ASSOCIATES OF TEXAS, PC",
        "enumeration_date": "2017-05-11",
        "last_updated": "2017-06-26",
        "status": "A",
        "authorized_official_last_name": "TEUTSCH",
        "authorized_official_first_name": "CASSANDRA",
        "authorized_official_middle_name": "NICHOLE",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-8972"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Energy Square Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2017; 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.