Individual provider Active NPI

Phillip Claassen, DMD

  • Dentist
  • Richardson, TX
National Provider Identifier
1205218526
Registry record updated Apr 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
40173 Issued in TX
Practice address
1050 W Campbell Rd
Richardson, TX 75080-2974
Phone
(239) 770-5159
NPI assigned
Jun 23, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 059600 NY
Dentist 122300000X DN21335 FL
Dentist 122300000X 40173 TX Primary

Addresses

Primary practice location

1050 W Campbell Rd
Richardson, TX 75080-2974

Mailing address

2825 Newburyport Ave
Garland, TX 75044-2113

Other identifiers 1

IdentifierTypeStateIssuer
017398600MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20160712001053 FL Order and Referring Only - DentistPractitioner - Dentist 2264744267

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
059600NYMDDentist
40173TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Claassen PLLC Dentist CurrentSince Apr 6, 2025 Accepting new patients

Networks

  • Freedom Health HMO Network

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": "1435017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743465600000",
    "number": "1205218526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2825 NEWBURYPORT AVE",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750442113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 W CAMPBELL RD",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750802974",
            "telephone_number": "239-770-5159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLAASSEN",
        "first_name": "PHILLIP",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-23",
        "last_updated": "2025-04-01",
        "certification_date": "2025-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "059600",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN21335",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "40173",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "017398600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richardson, TX

Sources for this page

Verify at the official NPI Registry.