Individual provider Active NPI

Bryan David Schelin, DMD

  • Dentist
  • Frisco, TX
National Provider Identifier
1184888463
Registry record updated Nov 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
24398 Issued in TX
Practice address
5105 Eldorado Pkwy
Suite 150
Frisco, TX 75034-8674
Phone
(214) 387-0745
NPI assigned
Jul 15, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 24398 TX Primary
Dentist 122300000X 57235 CA

Addresses

Primary practice location

5105 Eldorado Pkwy
Suite 150
Frisco, TX 75034-8674

Mailing address

5105 Eldorado Pkwy
Suite 150
Frisco, TX 75034-8674
Phone (214) 387-0745

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
I20150804005967 TX Order and Referring Only - DentistPractitioner - Dentist 4486968476

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
57235CAMDDentist
24398TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Eldorado Smiles and Orthodontics,PC 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.

NPI Registry JSON

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

{
    "created_epoch": "1216080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288742400000",
    "number": "1184888463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5105 ELDORADO PKWY",
            "address_2": "SUITE 150",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750348674",
            "telephone_number": "214-387-0745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5105 ELDORADO PKWY",
            "address_2": "SUITE 150",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750348674",
            "telephone_number": "214-387-0745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHELIN",
        "first_name": "BRYAN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-15",
        "last_updated": "2010-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "24398",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "57235",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frisco, TX

Sources for this page

Verify at the official NPI Registry.