Brent Andrew Collins, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

35407 Issued in TX

Practice address

1301 W Glade Rd Ste 110
Euless, TX 76039-5419

Phone

(817) 358-2008

NPI assigned

Jun 27, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Glade Modern Dentistry and Orthodontics, PC

  • Dentist
  • Euless, TX
  • NPI 1295171536
  NPD (past)

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

{
    "created_epoch": "1561593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561593600000",
    "number": "1245891597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4724 BILL SIMMONS RD",
            "city": "COLLEYVILLE",
            "state": "TX",
            "postal_code": "760344331",
            "telephone_number": "817-991-3883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 W GLADE RD STE 110",
            "city": "EULESS",
            "state": "TX",
            "postal_code": "760395419",
            "telephone_number": "817-358-2008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "BRENT",
        "middle_name": "ANDREW",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-27",
        "last_updated": "2019-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "35407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• City of Euless
• CK Mid-Cities Inc.
• Lauren Emily Coffman, DDS
• Bendu Coleman
• Tashara Coleman
• Comfortgo LLC
• Miles Christian Compton, PHARMD
• Jean C Connelly, R.N., A.C.N.P.
• Jennifer Contella
• Chris Craig, LMT

• General Practice Dentistry in Euless, TX
• Providers in Euless, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.