Chad Lamar Drennan, D.D.S.
Individual provider Active NPI General Practice Dentistry · Willow Park, TX
NPI 1265657126 · NPPES record last updated Jan 24, 2019
Key facts
- NPI
- 1265657126
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 22212 (TX)
- Practice address
- 220 Shops Blvd
Willow Park, TX 76087 - Phone
- (817) 441-7654
- Fax
- (817) 441-6168
- NPI assigned
- Apr 16, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150828000695 | TX | Order and Referring Only - Oral Surgery |
0345556825 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Crown Pointe Dentistry, PA | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 22212 | TX | Yes |
Addresses
Primary practice location
220 Shops Blvd
Willow Park, TX 76087
Mailing address
220 Shops Blvd
Willow Park, TX 76087
Phone (817) 441-7654
Other providers in Willow Park, TX
- Lauren Debolt
- Misty Diaz
- Matthew Dobbins
- Skylar Dominguez
- Ashley Drake Mertz
- Michael Ross Drennan
- Brynn Dunn
- Ebd Bemc Burleson, LLC
- Corinna Edgington
- Hannah Elder
All providers in Willow Park, TX · General Practice Dentistry in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 24, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.