Active NPI
Joel Trimble Edwards, DDS
- Pediatric Dentistry
- Odessa, TX
National Provider Identifier
1255521241
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 21784
- Practice address
- 1508 N Grandview Ave
Suite 5
Odessa, TX 79761-3000 - Phone
- (432) 272-1190
- Fax
- (800) 532-0728
- NPI assigned
- Jul 26, 2007
- Last updated
- Mar 7, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 21784 | TX | Primary |
Addresses
Primary practice location
1508 N Grandview Ave
Suite 5
Odessa, TX 79761-3000
Mailing address
1508 N Grandview Ave
Suite 5
Odessa, TX 79761-3000
Phone (432) 272-1190
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
| License | State | Type | Specialty |
|---|---|---|---|
| 21784 | TX | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Edwards and Gonzlez DDS PLLC | Pediatric Dentistry | Current | Accepting new patients |
| Joel T. Edwards, DDS PLLC | Pediatric Dentistry | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Pediatric Dentistry
- Odessa, TX
- NPI 1417186149
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1185408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1255521241",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1508 N GRANDVIEW AVE",
"address_2": "SUITE 5",
"city": "ODESSA",
"state": "TX",
"postal_code": "797613000",
"telephone_number": "432-272-1190",
"fax_number": "800-532-0728"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1508 N GRANDVIEW AVE",
"address_2": "SUITE 5",
"city": "ODESSA",
"state": "TX",
"postal_code": "797613000",
"telephone_number": "432-272-1190",
"fax_number": "800-532-0728"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDWARDS",
"first_name": "JOEL",
"middle_name": "TRIMBLE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-07-26",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "TX",
"license": "21784",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Odessa, TX
- Ector County Hosptial (Ronald McDonald Care Mobil)
- Ector County Isd
- George Oritsebemigho Ede
- Educare Community Living Corporation - Texas (All Ways Caring HomeCare)
- Edwards and Gonzlez DDS PLLC (Big Smiles Ranch)
- Eileen Li MD PA
- Amarachi Eke-Okoro
- Emade E Ekwelle, PHARMD
- Gary Wayne Elam, M.D.
- Alaa Eldin A Eldemerdash, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.