NPIMap

Organization Active NPI

Cottonwood Family Dental Associates

  • General Practice Dentistry
  • Richardson, TX
National Provider Identifier
1265768113
Registry record updated Oct 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7515 Issued in TX
Legal business name
COTTONWOOD FAMILY DENTAL ASSOCIATES
Practice address
208 S Cottonwood Dr
Richardson, TX 75080-5706
Phone
(972) 234-8080
Fax
(972) 644-2398
NPI assigned
Oct 28, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2009

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

Authorized official

Name
Dr. Ronald Cleo McConnellNPI 1427383462
Title
President
Phone
(972) 234-8080

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 7515 TX Primary

Addresses

Primary practice location

208 S Cottonwood Dr
Richardson, TX 75080-5706

Mailing address

208 S Cottonwood Dr
Richardson, TX 75080-5706
Phone (972) 234-8080

National Provider Directory

National Provider Directory

Locations

208 S Cottonwood Dr
Richardson, TX 75080
Phone (972) 234-8080

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": "1256688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256688000000",
    "number": "1265768113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 S COTTONWOOD DR",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750805706",
            "telephone_number": "972-234-8080",
            "fax_number": "972-644-2398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 S COTTONWOOD DR",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750805706",
            "telephone_number": "972-234-8080",
            "fax_number": "972-644-2398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COTTONWOOD FAMILY DENTAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-28",
        "last_updated": "2009-10-28",
        "status": "A",
        "authorized_official_last_name": "MCCONNELL",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "CLEO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-234-8080",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "7515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richardson, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2009; 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.