NPIMap

Organization Active NPI

TX-SCD Dental PC

  • General Practice Dentistry
  • Odessa, TX
National Provider Identifier
1154761138
Registry record updated Jul 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
28860 Issued in TX
Legal business name
TX-SCD DENTAL PC
Practice address
6105 E Highway 191
Odessa, TX 79762
Phone
(315) 454-6000
NPI assigned
Jul 5, 2013
Last updated
Jul 19, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2013

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

Authorized official

Name
Dr. Scott C Dickinson, DMDNPI 1942432729
Title
Owner
Phone
(315) 454-6000

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 28860 TX Primary

Addresses

Primary practice location

6105 E Highway 191
Odessa, TX 79762

Mailing address

PO Box 3189
Syracuse, NY 13220-3189
Phone (315) 454-6000

National Provider Directory

National Provider Directory

Locations

6105 E Highway 191
Odessa, TX 79762

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": "1372982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374192000000",
    "number": "1154761138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3189",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132203189",
            "telephone_number": "315-454-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6105 E HIGHWAY 191",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "79762",
            "telephone_number": "315-454-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TX-SCD DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-05",
        "last_updated": "2013-07-19",
        "status": "A",
        "authorized_official_last_name": "DICKINSON",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "315-454-6000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "28860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Odessa, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 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.