Active NPI
Mary Courtin, D.D.S.
- General Practice Dentistry
- Rockwall, TX
National Provider Identifier
1174713069
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 23482
- Practice address
- 991 E Interstate 30
Suite 103
Rockwall, TX 75087-4824 - Phone
- (972) 722-0022
- Fax
- (972) 722-0017
- NPI assigned
- Jul 27, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 23482 | TX | Primary |
Addresses
Primary practice location
991 E Interstate 30
Suite 103
Rockwall, TX 75087-4824
Mailing address
991 Ei30
Suite 103
Rockwall, TX 75087-4824
Phone (972) 722-0022
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 23482 | Other | TX | CHIP NUMBER |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23482 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Floss Rockwall PC | General Practice | 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
- Rockwall, TX
- NPI 1396076907
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1185494400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1375315200000",
"number": "1174713069",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "991 EI30",
"address_2": "SUITE 103",
"city": "ROCKWALL",
"state": "TX",
"postal_code": "750874824",
"telephone_number": "972-722-0022",
"fax_number": "972-722-0017"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "991 E INTERSTATE 30",
"address_2": "SUITE 103",
"city": "ROCKWALL",
"state": "TX",
"postal_code": "750874824",
"telephone_number": "972-722-0022",
"fax_number": "972-722-0017"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COURTIN",
"first_name": "MARY",
"name_prefix": "Ms.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-07-27",
"last_updated": "2013-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "23482",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHIP NUMBER",
"identifier": "23482",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rockwall, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 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.