Individual provider Active NPI

Aly Assad Sergie, DDS

  • General Practice Dentistry
  • Dallas, TX
National Provider Identifier
1205033271
Registry record updated Dec 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
23444 Issued in TX
Practice address
2717 Howell St Ste D
Dallas, TX 75204-1137
Phone
(214) 242-0960
NPI assigned
Jul 2, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 23444 TX Primary

Addresses

Primary practice location

2717 Howell St Ste D
Dallas, TX 75204-1137

Mailing address

2717 Howell St Ste D
Dallas, TX 75204-1137
Phone (214) 242-0960

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
23444TXMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1183334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385942400000",
    "number": "1205033271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2717 HOWELL ST STE D",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752041137",
            "telephone_number": "214-242-0960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2717 HOWELL ST STE D",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752041137",
            "telephone_number": "214-242-0960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERGIE",
        "first_name": "ALY",
        "middle_name": "ASSAD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-02",
        "last_updated": "2013-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "23444",
            "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 Dec 2, 2013; 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.