Individual provider Active NPI

Daniel B Strader, DDS

  • Dentist
  • Dallas, TX
National Provider Identifier
1174666804
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
11291 Issued in TX
Practice address
8222 Douglas Ave
Suite 810
Dallas, TX 75225-5923
Phone
(214) 363-7777
NPI assigned
Feb 14, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 11291 TX Primary

Addresses

Primary practice location

8222 Douglas Ave
Suite 810
Dallas, TX 75225-5923

Mailing address

8222 Douglas Ave
Suite 810
Dallas, TX 75225-5923
Phone (214) 363-7777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150618001124 TX Order and Referring Only - DentistPractitioner - Dentist 1456662329

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11297TXMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174666804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8222 DOUGLAS AVE",
            "address_2": "SUITE 810",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752255923",
            "telephone_number": "214-363-7777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8222 DOUGLAS AVE",
            "address_2": "SUITE 810",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752255923",
            "telephone_number": "214-363-7777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STRADER",
        "first_name": "DANIEL",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "11291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.