NPIMap

Organization Active NPI

Palestine Dental PLLC

  • General Practice Dentistry
  • Palestine, TX
National Provider Identifier
1174907315
Registry record updated Jul 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
23695 Issued in TX
Legal business name
PALESTINE DENTAL PLLC
Practice address
419 Old Elkhart Rd
110
Palestine, TX 75801-5922
Phone
(903) 723-4669
NPI assigned
Jul 17, 2015
Last updated
Jul 17, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2015

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

Authorized official

Name
Everett C Evans, DDS
Title
Owner, DDS
Phone
(940) 808-1970

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 23695 TX Primary

Addresses

Primary practice location

419 Old Elkhart Rd
110
Palestine, TX 75801-5922

Mailing address

PO Box 674330
Dallas, TX 75267-4330
Phone (940) 808-1970

National Provider Directory

National Provider Directory

Locations

419 Old Elkhart Rd
Ste 110
Palestine, TX 75801
Phone (903) 723-4669

Practitioners & affiliated clinicians

Practitioners 8

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": "1437091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437091200000",
    "number": "1174907315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 674330",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752674330",
            "telephone_number": "940-808-1970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 OLD ELKHART RD",
            "address_2": "110",
            "city": "PALESTINE",
            "state": "TX",
            "postal_code": "758015922",
            "telephone_number": "903-723-4669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALESTINE DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-17",
        "last_updated": "2015-07-17",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "EVERETT",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER, DDS",
        "authorized_official_telephone_number": "940-808-1970",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "23695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palestine, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2015; 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.