Main St Dental PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

MAIN ST DENTAL PLLC

Practice address

921 E Main Ave Ste 2
Alton, TX 78573-1606

Phone

(956) 583-5050

Fax

(956) 583-5067

NPI assigned

May 21, 2019

Last updated

May 21, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Patrick Whilby, DDS

Title

Owner/Dentist

Phone

(956) 583-5050

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1558396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1558396800000",
    "number": "1164089645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 E MAIN AVE STE 2",
            "city": "ALTON",
            "state": "TX",
            "postal_code": "785731606",
            "telephone_number": "956-583-5050",
            "fax_number": "956-583-5067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 E MAIN AVE STE 2",
            "city": "ALTON",
            "state": "TX",
            "postal_code": "785731606",
            "telephone_number": "956-583-5050",
            "fax_number": "956-583-5067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN ST DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-21",
        "last_updated": "2019-05-21",
        "status": "A",
        "authorized_official_last_name": "WHILBY",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "956-583-5050",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Alton, TX
• Providers in Alton, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2019; 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.