Fadal Pediatric Dentistry, PA

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

FADAL PEDIATRIC DENTISTRY, PA

Practice address

5 Doctor Cir
Longview, TX 75605-5050

Phone

(903) 758-6406

Fax

(903) 758-8116

NPI assigned

Oct 13, 2014

Organization subpart

No

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

Authorized official

Name

Debbie Harris

Title

Office Manager

Phone

(903) 758-6406

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1413158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413158400000",
    "number": "1194129627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 DOCTOR CIR",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756055050",
            "telephone_number": "903-758-6406",
            "fax_number": "903-758-8116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 DOCTOR CIR",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756055050",
            "telephone_number": "903-758-6406",
            "fax_number": "903-758-8116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FADAL PEDIATRIC DENTISTRY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-13",
        "last_updated": "2014-10-13",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "903-758-6406"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Dentistry in Longview, TX
• Providers in Longview, TX by specialty
• Pediatric Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2014; 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.