NPIMap

Organization Active NPI

Legacy Trails Dental, PLLC

Doing business as LT Dental

  • Dental Clinic/Center
  • Plano, TX
National Provider Identifier
1245684430
Registry record updated Apr 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
LEGACY TRAILS DENTAL, PLLC
Doing business as
LT Dental
Practice address
4800 Hedgcoxe Rd
Suite # 150
Plano, TX 75024-2403
Phone
(214) 227-1000
NPI assigned
Apr 14, 2016
Last updated
Apr 14, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2016

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

Authorized official

Name
Dr. Afshin Azmoodeh, D.D.S.
Title
Manager
Phone
(214) 227-1000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

4800 Hedgcoxe Rd
Suite # 150
Plano, TX 75024-2403

Mailing address

4800 Hedgcoxe Rd
Suite # 150
Plano, TX 75024-2403
Phone (214) 227-1000

Other names 1

  • LT Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Canyon Creek Family Dentistry Plano PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1460592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460592000000",
    "number": "1245684430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 HEDGCOXE RD",
            "address_2": "SUITE # 150",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750242403",
            "telephone_number": "214-227-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 HEDGCOXE RD",
            "address_2": "SUITE # 150",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750242403",
            "telephone_number": "214-227-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY TRAILS DENTAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-14",
        "last_updated": "2016-04-14",
        "status": "A",
        "authorized_official_last_name": "AZMOODEH",
        "authorized_official_first_name": "AFSHIN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "214-227-1000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LT Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2016; 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.