Organization Active NPI

Mark Duane Perry

  • General Practice Dentistry
  • New Boston, TX
National Provider Identifier
1245500099
Registry record updated Jan 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
16865 Issued in TX
Legal business name
MARK DUANE PERRY
Practice address
104 Tyson St
New Boston, TX 75570-2820
Phone
(903) 628-3312
Fax
(903) 628-5631
NPI assigned
Jan 11, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2012

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

Authorized official

Name
Dr. Mark Duane Perry, DDS
Title
Doctor
Phone
(903) 628-3312

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 16865 TX Primary

Addresses

Primary practice location

104 Tyson St
New Boston, TX 75570-2820

Mailing address

104 Tyson
New Boston, TX 75570-2028
Phone (903) 628-3312

National Provider Directory

National Provider Directory

Locations

104 Tyson St
New Boston, TX 75570
Phone (903) 628-3312

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1326240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326240000000",
    "number": "1245500099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 TYSON",
            "city": "NEW BOSTON",
            "state": "TX",
            "postal_code": "755702028",
            "telephone_number": "903-628-3312",
            "fax_number": "903-628-5631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 TYSON ST",
            "city": "NEW BOSTON",
            "state": "TX",
            "postal_code": "755702820",
            "telephone_number": "903-628-3312",
            "fax_number": "903-628-5631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK DUANE PERRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-11",
        "last_updated": "2012-01-11",
        "status": "A",
        "authorized_official_last_name": "PERRY",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "DUANE",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "903-628-3312",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "16865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Boston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2012; 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.