NPIMap

Organization Active NPI

David Bernal DDS, PLLC

  • Dentist
  • Port Arthur, TX
National Provider Identifier
1124317375
Registry record updated May 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
24729 Issued in TX
Legal business name
DAVID BERNAL DDS, PLLC
Practice address
7675 Memorial Blvd
Suite 200
Port Arthur, TX 77640
Phone
(409) 853-3100
Fax
(409) 727-3249
NPI assigned
Mar 28, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2013

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

Authorized official

Name
Dr. David Bernal, DDSNPI 1245437102
Title
Owner
Phone
(409) 853-3100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 24729 TX Primary

Addresses

Primary practice location

7675 Memorial Blvd
Suite 200
Port Arthur, TX 77640

Mailing address

7675 Memorial Blvd
Suite 200
Port Arthur, TX 77640
Phone (409) 853-3100

Other identifiers 1

IdentifierTypeStateIssuer
209014402MedicaidTX

National Provider Directory

National Provider Directory

Locations

7675 Memorial Blvd
Ste 200
Port Arthur, TX 77640
Phone (409) 853-3100

Practitioners & affiliated clinicians

Practitioners 1

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": "1301270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368403200000",
    "number": "1124317375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7675 MEMORIAL BLVD",
            "address_2": "SUITE 200",
            "city": "PORT ARTHUR",
            "state": "TX",
            "postal_code": "77640",
            "telephone_number": "409-853-3100",
            "fax_number": "409-727-3249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7675 MEMORIAL BLVD",
            "address_2": "SUITE 200",
            "city": "PORT ARTHUR",
            "state": "TX",
            "postal_code": "77640",
            "telephone_number": "409-853-3100",
            "fax_number": "409-727-3249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID BERNAL DDS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-28",
        "last_updated": "2013-05-13",
        "status": "A",
        "authorized_official_last_name": "BERNAL",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "409-853-3100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "24729",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209014402",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Arthur, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2013; 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.