NPIMap

Organization Active NPI

411 Dental PC Dba Harris Creek Dental

  • General Practice Dentistry
  • McGregor, TX
National Provider Identifier
1124489935
Registry record updated Mar 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
25535 Issued in TX
Legal business name
411 DENTAL PC DBA HARRIS CREEK DENTAL
Practice address
27487 W Highway 84
MC Gregor, TX 76657-3717
Phone
(254) 848-9566
NPI assigned
Mar 8, 2016
Last updated
Mar 8, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2016

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

Authorized official

Name
Sam M Baber, DDSNPI 1013238435
Title
President
Phone
(254) 848-9566

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 25535 TX Primary

Addresses

Primary practice location

27487 W Highway 84
MC Gregor, TX 76657-3717

Mailing address

27487 W Highway 84
MC Gregor, TX 76657-3717

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1457395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457395200000",
    "number": "1124489935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27487 W HIGHWAY 84",
            "city": "MC GREGOR",
            "state": "TX",
            "postal_code": "766573717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27487 W HIGHWAY 84",
            "city": "MC GREGOR",
            "state": "TX",
            "postal_code": "766573717",
            "telephone_number": "254-848-9566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "411 DENTAL PC DBA HARRIS CREEK DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-08",
        "last_updated": "2016-03-08",
        "status": "A",
        "authorized_official_last_name": "BABER",
        "authorized_official_first_name": "SAM",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "254-848-9566",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "25535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McGregor, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2016; 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.