Active NPI
Nicholas L Neville, DDS,MD
- Periodontics
- Dallas, TX
National Provider Identifier
1174631378
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 16984
- Practice address
- 5706 E Mockingbird LN Ste 200
Dallas, TX 75206-5400 - Phone
- (214) 821-0907
- NPI assigned
- Aug 28, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 16984 | TX | Primary |
Addresses
Primary practice location
5706 E Mockingbird LN Ste 200
Dallas, TX 75206-5400
Mailing address
6538 Bob O Link Dr
Dallas, TX 75214-3135
Phone (214) 823-3917
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16984 | TX | MD | Periodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Neville Dental PA | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Dentistry
- Dallas, TX
- NPI 1366769846
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156723200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1174631378",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6538 BOB O LINK DR",
"city": "DALLAS",
"state": "TX",
"postal_code": "752143135",
"telephone_number": "214-823-3917"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5706 E MOCKINGBIRD LN STE 200",
"city": "DALLAS",
"state": "TX",
"postal_code": "752065400",
"telephone_number": "214-821-0907"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEVILLE",
"first_name": "NICHOLAS",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "DDS,MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "TX",
"license": "16984",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.