Individual provider Active NPI

Elizabeth Dodge, MD

  • Psychiatry Physician
  • Dallas, TX
National Provider Identifier
1184814337
Registry record updated Jan 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
N8779 Issued in TX
Practice address
2200 Dennison St
Dallas, TX 75212-2460
Phone
(972) 502-4190
NPI assigned
Jul 25, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X N8779 TX
Psychiatry Physician 2084P0800X N8779 TX Primary

Addresses

Primary practice location

2200 Dennison St
Dallas, TX 75212-2460

Mailing address

12880 Hillcrest Rd
Suite J104
Dallas, TX 75230-1532
Phone (214) 866-0222

Other practice location 1

12880 Hillcrest Rd
Suite J104
Dallas, TX 75230-1532
Phone (214) 866-0222

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
N8779TXMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1185321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546992000000",
    "number": "1184814337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12880 HILLCREST RD",
            "address_2": "SUITE J104",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752301532",
            "telephone_number": "214-866-0222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 DENNISON ST",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752122460",
            "telephone_number": "972-502-4190"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12880 Hillcrest Rd",
            "address_2": "Suite J104",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752301532",
            "country_code": "US",
            "telephone_number": "214-866-0222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DODGE",
        "first_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-25",
        "last_updated": "2019-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "TX",
            "license": "N8779",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "N8779",
            "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 Jan 9, 2019; 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.