Active NPI
Edward P. Allen, DDS, PH.D
- Periodontics
- Dallas, TX
National Provider Identifier
1184763013
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 8914
- Practice address
- 8335 Walnut Hill LN
Suite 210
Dallas, TX 75231-4216 - Phone
- (214) 696-1414
- Fax
- (214) 691-8174
- NPI assigned
- Feb 6, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 8914 | TX | Primary |
Addresses
Primary practice location
8335 Walnut Hill LN
Suite 210
Dallas, TX 75231-4216
Mailing address
8335 Walnut Hill LN
Suite 210
Dallas, TX 75231-4216
Phone (214) 696-1414
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150115001145 | TX | Order and Referring Only - Oral Surgery | 2668796905 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8914 | TX | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1184763013",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8335 WALNUT HILL LN",
"address_2": "SUITE 210",
"city": "DALLAS",
"state": "TX",
"postal_code": "752314216",
"telephone_number": "214-696-1414",
"fax_number": "214-691-8174"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8335 WALNUT HILL LN",
"address_2": "SUITE 210",
"city": "DALLAS",
"state": "TX",
"postal_code": "752314216",
"telephone_number": "214-696-1414",
"fax_number": "214-691-8174"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALLEN",
"first_name": "EDWARD",
"middle_name": "P.",
"name_prefix": "Dr.",
"credential": "DDS, PH.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "TX",
"license": "8914",
"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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.